2016 年 29 巻 3 号 p. 181-184
A 71-year-old woman was admitted to our hospital with an acute Stanford type A aortic dissection. She underwent tricuspid valve plasty and ascending aorta repair. On day 7 she presented with aphasia. Brain computed tomography (CT) revealed a low-density area in the left frontal lobe. Carotid Doppler ultrasonography disclosed that the left common carotid artery was occluded up to a point just proximal to the carotid bifurcation, and retrograde flow was seen from the external carotid artery (ECA) to the internal carotid artery via the carotid bifurcation. These findings suggested a collateral anastomosis between the ECA and the vertebral artery. Four-dimensional CT angiography is sufficiently effective for evaluation of occipital-vertebral anastomosis.