Síndrome do "coto" da carótida interna: relato de caso

Moreira, R.C.R.; Sandmann, M. C.; Gracia, C.M.G.

doi:10.1590/S0004-282X1994000100013

Resumos

Os autores relatam o caso de um paciente com ataques isquêmicos transitórios (AITs) cuja fonte de êmbolos originou-se ipsilateralmente ao fundo de saco de uma carótida interna ocluída (carotid stump syndrome). O paciente foi submetido a ressecção cirúrgica do "coto" (stump), com alívio total dos sintomas. O tromboembolismo decorrente do fundo de saco ou coto, documentado por arteriografia, se faz através das artérias anastomóticas, sendo agravado pela turbulência do fluxo sangüíneo a esse nível.

ataques isquêmicos transitórios; oclusão da carótida interna; síndrome do coto da carótida

The authors describe the case of a pacient with transient isquemic attacks (TIAs) from the ipsilateral occluded internal carotid artery (carotid stump syndrome). The patient was submitted to surgical resection of the stump with relief of the symptoms. Thromboembolism from the stump via the anastomotic supply is responsable for the TIAs and is worsened by the blood flow turbulence at this level.

transient isquemic attacks; internal carotid artery occlusion; carotid stump syndrome

Síndrome do "coto" da carótida interna: relato de caso

Carotid stump syndrome: case report

R.C.R. Moreira^I; M. C. Sandmann^II; C.M.G. Gracia

RESUMO

Os autores relatam o caso de um paciente com ataques isquêmicos transitórios (AITs) cuja fonte de êmbolos originou-se ipsilateralmente ao fundo de saco de uma carótida interna ocluída (carotid stump syndrome). O paciente foi submetido a ressecção cirúrgica do "coto" (stump), com alívio total dos sintomas. O tromboembolismo decorrente do fundo de saco ou coto, documentado por arteriografia, se faz através das artérias anastomóticas, sendo agravado pela turbulência do fluxo sangüíneo a esse nível.

Palavras-chave: ataques isquêmicos transitórios, oclusão da carótida interna, síndrome do coto da carótida.

SUMMARY

The authors describe the case of a pacient with transient isquemic attacks (TIAs) from the ipsilateral occluded internal carotid artery (carotid stump syndrome). The patient was submitted to surgical resection of the stump with relief of the symptoms. Thromboembolism from the stump via the anastomotic supply is responsable for the TIAs and is worsened by the blood flow turbulence at this level.

Key words: transient isquemic attacks, internal carotid artery occlusion, carotid stump syndrome.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 12-julho-1993.

Estudo realizado no Serviço de Cirurgia Vascular e Neurologia do Hospital Nossa Senhora das Graças, Curitiba.

Dr. Ricardo C. R. Moreira - Rua Alcides Munhoz, 433 - 80810-040 Curitiba PR - Brasil.

1. Barnett HJM, Peerless SJ, Kaufmann JCE. "Stump" of internal carotid artery: a source for further cerebral embolic ischaemia. Stroke 1978,9:448-456.
2. Birnbaum MD, Selhorst JB, Harbison JW etal. Amaurosis fugax from disease of the external carotid artery. Arch Neurol 1977, 34: 532-535.
3. Black SE, Norris JW, Hachinski VC. Post-stroke seizures (abstract). Stroke 1983,14:134.
4. Blaisdell WF, Clauss RH, Galbraith JG, et al. Joint study of extracranial arterial occlusion: IV. A review of surgical considerations. JAMA 1969,209:1889-1895.
5. Bogousslavsky J, Regli F, Hungerbuhler J, et al. Transient ischaemic attacks and the external carotid artery: a retrospective study of 23 patients with an occlusion of the internal carotid artery. Stroke 1981,12:627-630.
6. Burnett JR, Lusby RJ. Internal carotid artery occlusion: effect of contralateral flow reduction in inducing symptoms. J Vase Surg 1989, 9:115-123.
7. Dodge PR, Richardson EP, Victor M.Recurrent convulsive seizures as a sequel to cerebral infarction: a clinical and pathological study. Brain 1954,77:610-638.
8. Fritz VU, Voll CL, Levien LJ. Internal carotid artery occlusion: clinical and therapeutic implications. Stroke 1985, 16:940-944.
9. Furlan AJ, Whisnant JP, Baker HL. Long-term prognosis after carotid artery occlusion. Neurology 1980,30:986-988.
10. Gertler JP, Cambria RP. The role of external carotid endarterectomy in the treatment of ipsilateral internal carotid occlusion: collective review. J Vase Surg 1987,6:158-167.
11. Gupta SR, Naheedy MH, Elias D, Rubino FA. Postinfarction seizures: a clinical study.Stroke 1988,19:1477-1481.
12. Holmes GL. The electroencephalogram as a predictor of seizures following cerebral infarction. Clin Electroencephalogr 1980, 11:83-86.
13. Meyer JS, Charney JZ, Rivera VM, Mathew NT. Cerebral embolisation: prospective clinical analysis of 42 cases. Stroke 1971, 2:541-554.
14. Quill DS, Colgan MP, Summer DS. Carotid stump syndrome: a colour-coded Doppler flow study. Eur J Vase Surg 1989, 3:79-83.
15. Sterpetti AV, Schultz RD, Feldhaus RJ. External carotid endarterectomynndications, techniques and late results. J Vase Surg 1988, 7:31-39.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Mar 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Barnett HJM, Peerless SJ, Kaufmann JCE. "Stump" of internal carotid artery: a source for further cerebral embolic ischaemia. Stroke 1978,9:448-456.

[2] 2. Birnbaum MD, Selhorst JB, Harbison JW etal. Amaurosis fugax from disease of the external carotid artery. Arch Neurol 1977, 34: 532-535.

[3] 3. Black SE, Norris JW, Hachinski VC. Post-stroke seizures (abstract). Stroke 1983,14:134.

[4] 4. Blaisdell WF, Clauss RH, Galbraith JG, et al. Joint study of extracranial arterial occlusion: IV. A review of surgical considerations. JAMA 1969,209:1889-1895.

[5] 5. Bogousslavsky J, Regli F, Hungerbuhler J, et al. Transient ischaemic attacks and the external carotid artery: a retrospective study of 23 patients with an occlusion of the internal carotid artery. Stroke 1981,12:627-630.

[6] 6. Burnett JR, Lusby RJ. Internal carotid artery occlusion: effect of contralateral flow reduction in inducing symptoms. J Vase Surg 1989, 9:115-123.

[7] 7. Dodge PR, Richardson EP, Victor M.Recurrent convulsive seizures as a sequel to cerebral infarction: a clinical and pathological study. Brain 1954,77:610-638.

[8] 8. Fritz VU, Voll CL, Levien LJ. Internal carotid artery occlusion: clinical and therapeutic implications. Stroke 1985, 16:940-944.

[9] 9. Furlan AJ, Whisnant JP, Baker HL. Long-term prognosis after carotid artery occlusion. Neurology 1980,30:986-988.

[10] 10. Gertler JP, Cambria RP. The role of external carotid endarterectomy in the treatment of ipsilateral internal carotid occlusion: collective review. J Vase Surg 1987,6:158-167.

[11] 11. Gupta SR, Naheedy MH, Elias D, Rubino FA. Postinfarction seizures: a clinical study.Stroke 1988,19:1477-1481.

[12] 12. Holmes GL. The electroencephalogram as a predictor of seizures following cerebral infarction. Clin Electroencephalogr 1980, 11:83-86.

[13] 13. Meyer JS, Charney JZ, Rivera VM, Mathew NT. Cerebral embolisation: prospective clinical analysis of 42 cases. Stroke 1971, 2:541-554.

[14] 14. Quill DS, Colgan MP, Summer DS. Carotid stump syndrome: a colour-coded Doppler flow study. Eur J Vase Surg 1989, 3:79-83.

[15] 15. Sterpetti AV, Schultz RD, Feldhaus RJ. External carotid endarterectomynndications, techniques and late results. J Vase Surg 1988, 7:31-39.