Stroke EtiologyCarotid

DDr.Serdar Geyik

• atherosclerosis• dissection• fmd• vasculitis• web

LUMEN NORMAL NARROW OCCLUSİON

THROMBUS PROXİMAL MİD DİSTAL

TERRİTORY NORMAL F FRAGMENT LVO

ANGİOGRAPHİC PATTERNS of CAROTİD STROKE

how it looks?

non-stenotic vulnerable plaque,distal emboli

acute left hemiparesis

63y,M, nıhss:21, disrupted plaque, mca occlusion 60y, M, nıhss:10, tandem, ICA+MCA

post-PTApseudo-occlusion CCA

60y, M, nıhss:10, tandem, ICA+MCA

74y,M, nıhss:24,tandem, large clot, less narrow 74y,M, nıhss:24,tandem,ICA orgin-tip, MCA

34y,M, onset:20 hours, nıhss:10severe narrowed,long thrombus at lumen

young patient, severe narrowing, long thrombus

• high lipid/ necrotic core• fibrous cap thinning/ inflammation• ulceration• intraplaque hemorrhage

intra-plaque hemorrhage?? (mainly observed in surgery)

thrombus up to cavernous segment

ulceration

single

multiple

60y,M,nıhss:10, single ulcer, narrow ICA, mca occlusion

risk of stroke increases with ulcer!!!

T.Y.

a b c d

T.Y.

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admission week after

admission month after

courtesy of Dr.Andic

DWI 24h FU SWI 24h FU CT 8h FU

49y,F, onset 20hours

DWI-PWI admission

courtesy of Dr.Baltaci

55y,M, left hemiparesis

47,F, onset 30 min neuroform atlas after 6 month

failed access-Takayasu arteritis, progression

67y, F, nıhss 10,mca occlusion

web ?? atherosclerosis?? or both

thanks…