MedPix® Patient Chart - Case No: 4798 :: - Review Images

57 year-old male with left amaurosis fugax and left frontal headache. No history of trauma except for a syncopal episode approximately 8 months prior to the onset of symptoms.

PMHx: Mild urinary retention. No history of HTN, CAD, MI or DM
Non-smoker, retired pilot

Normal physical exam and laboratory evaluation.

- Review Images for PT: 4798

DIAGNOSTIC EVALUATION: CT scan of the head was normal. MRI with DWI revealed nonspecific foci of increased signal consistent with microvascular ischemic changes without findings of large vessel ischemic changes or edema. Carotid duplex ultrasound demonstrated a very narrowed left internal carotid artery. The patient was referred to Interventional Radiology for carotid angiogram to evaluate for possible carotid artery dissection. Left carotid arteriogram showed a smooth tapered narrowing of the proximal left internal carotid artery near its origin with delayed washout of contrast consistent with left internal carotid artery dissection extending from the bulb to the intracranial internal carotid artery. The aortic arch, right carotid artery and remaining intracranial vessels examined were normal. There was no evidence of atherosclerotic vascular disease. The etiology of this patient’s carotid artery dissection was unclear.

- Review Images for PT: 4798

None

- Review Images for PT: 4798

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Treatment not available without Diagnosis

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