Carotid Artery Blockage causing Left Parietal Lobe Infarct

A Surgical intervention can save a patient's life if done at an appropriate time. Share your views on this case of Carotid Artery Blockage presented by Dr. Jaideep Chandra. Enhance your clinical knowledge by learning thorough his rich experience. Follow us for more such Updates!

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A very informative Experts Insights clinical case presentaion by Dr Jaideep Chandra- Neurosurgeon and one of the difficult surgeries performed. Always surgery in neck region is difficult and most surgeons like me try to avoid neck surgeries considering the major vessels like carotid artery and internal jugular vein present there. The big sized atheroma which was removed was enough to cause left Parietal lobe infarct. people with carotid stenosis have no symptoms until the artery becomes severely narrowed or a clot forms. Symptoms are most likely to first appear with a mini-stroke, also known as a transient ischemic attack (TIA). TIAs result when blood flow to the brain is temporarily interrupted and then restored. The symptoms typically last a couple of minutes and then resolve completely, and the person returns to normal. TIAs should not be ignored; they are a warning that an ischemic stroke and permanent brain injury may be looming. Symptoms of a TIA or an ischemic stroke can include weakness or numbness in an arm or leg, difficulty speaking, a drooping face, vision problems, or paralysis affecting one side of the body. If you or a loved one develops these symptoms, you should immediately shift the patient to ED

Avery knowledge able view.. thanks Doctor
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NICE ILLUSTRATION YES I AGREE WITH THE STATEMENT THAT A SURGICAL INTERVENTION CAN SAVE A PATIENTS LIFE IF DONR AT AN APPROPRIATE TIME APPENDICITIS CAN BE A VERY TRICKY MODALITY IF NOT OPERATED IN TIME CAN LEAD TO COMPLECATIONS OF PERITONITIS BURSTING OF APPENDEX AND EVEN WE CAN LOOSE THE PATIENT INTESTINAL OBSTRUCTION IS ANOTHER MODALITY HOWERVER AT PRESENT WE HAVE SUBSPECIALITIES AND VARIOUS DIAGNOSTIC TOOKS WHICH HELP NUS IN DC LIKE ULTRASOUND CT SCAN

Excellent management of stroke resulting in significant improvement in clinical condition Carotid endarterectomy is gold standard treatment modality in a case of symptomatic carotid stenosis which are causing more than 50% block of carotid lumen All other modalities of treatment such as carotid angiography and stenting are compared against Gold standard treatment of carotid endarterectomy

Nicely treated a case of carotid artery occlusion with endarterectomy procedure to take out atheromata keeping intact carotid bulb , protecting hypoglossal Vegus and recurrent laryngeal and ansacervical nerves with positive results complete recovery of speech and hemiparesis Congratulations Dr Jaideep Chandra

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Thank you all for your insights and comments,. This was indeed a challenging case. I would like to add, that a carotid doppler should be done in all cases of ischemic stroke. This is not routinely done by the majority

NICE ILLUSTRATION COMMON CAROTID ARTERY AT THE LEVEL OF THYROID DIVIDES IN TO 2 BRANCHES EXTERNAL CAROTID ARTERY INTERNA CAROTID ARTERY BRACHES OF EXTERNAL CAROTID ARTERY ARE SUPROTEMPORAL ARTERY LINGUAL FACIAL ASCENDING PHARYGEAL OCCIPITAL POST AURICULAR MAXILLARY TERMINAL BRACH OF MAXILLARY IS TEMPORAL ARTERY

Very well presentation and very informative case with nicely discribed everything with procedure details and good outcome. Well done . One question In history said Patient was bedridden but i seen in Examination part there is " cremasteric reflex absent " please explain how to check this reflex in bedridden Patient please ?? Thanks

IN MUMBAI AT KEM HOSPITAL SUCH FACILITY IS AVAILABLE FOR ONCE PT IS SHIFTED IN GOLDEN HRS AT CASUALTY FULL FLEDE UNIT WITH MRI ANGIO ANGIO CATH AND LAP UNDER ONE UNIT NEXT TO CASUALTY

TRANSFEMORAL ANGIOCATH IS PASSED IN AFFECTED INTERNAL CAROTID ARTERY AND ITS TRIBUTARY LOCATE THE EMBOLUS AND REMOVE THROUGH SAME ANGIOCATH ITSELF
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Nicely explained the causes and pathophysiology and exploration of the site and demonstrating the structures come across the procedure and it is also nice to the pt who was bedridden came of his own for follow up. All these pointed us right time intervention gives better results. Thanks for your excellency.

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