Left ICA infarct

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Dense right hemiplegia and aphasia following carotid endarterectomy.

Patient Data

Age: Elderly
ct

Single axial CT image demonstrates subtle hypodensities in left anterior and posterior watershed areas.

mri

Selected images from an MRI performed later the same day demonstrates lack of flow induced signal in the left ICA and attenuated flow in the left MCA and both ACA. This is associated with extensive infarction of the left hemisphere and right ACA territory. 

Case Discussion

This patient had a carotid endarterectomy on the left the day before the CT brain. Dense right hemiplegia and aphasia. They proceeded to become obtunded and eventually passed away. 

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