두개내 협착이 동반된 두개외 경동맥 협착에서 경동맥 절제술이후의 관류 개선 : 18FDG-PET 상의 변화를 보인 1 례
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Background : In surgical treament of extracranial carotid artery stenosis, the presence of intrcranial atherosclerotic disease (IAD) may affect the perioperative surgical risk and long-term outcome. The prevalence of IAD in Korea seems to be high compared with that in western country. Case report : A 60-year-old hypertensive woman visted our hospital because of transient dysarthria and sensory change on her right face. The same symptoms recurred after ten days. Carotid bruit was audible on her left neck. Small ischemic lesions were seen on right basal ganglia and both thalami on brain MRI. Cerebral angiography revealed severe stenosis ( > 95%) of the left proximal internal carotid artery (ICA) along with significant middle cerebral artery stenosis ( >70%). Diamox -18F -fluorodeoxyglucose (18FDG) Positron emission tomography (FET) was done to compare between preoperative and postoperative metabolic (perfusion) status. Significant improvement of metabolic (perfusion) status was observed after carotid endarterectomy in the presence of IAD. Conclusion : This case suggests that carotid endarterectomy may be beneficial in patients with both severe extracranial ICA stenosis and IAD. Korean Journal of Stroke 1999;1(2): 263~267
Abstract
Background : In surgical treament of extracranial carotid artery stenosis, the presence of intrcranial atherosclerotic disease (IAD) may affect the perioperative surgical risk and long-term outcome. The prevalence of IAD in Korea seems to be high compared with that in western country. Case report : A 60-year-old hypertensive woman visted our hospital because of transient dysarthria and sensory change on her right face. The same symptoms recurred after ten days. Carotid bruit was audible on her left neck. Small ischemic lesions were seen on right basal ganglia and both thalami on brain MRI. Cerebral angiography revealed severe stenosis ( > 95%) of the left proximal internal carotid artery (ICA) along with significant middle cerebral artery stenosis ( >70%). Diamox -18F -fluorodeoxyglucose (18FDG) Positron emission tomography (FET) was done to compare between preoperative and postoperative metabolic (perfusion) status. Significant improvement of metabolic (perfusion) status was observed after carotid endarterectomy in the presence of IAD. Conclusion : This case suggests that carotid endarterectomy may be beneficial in patients with both severe extracranial ICA stenosis and IAD. Korean Journal of Stroke 1999;1(2): 263~267