著者

友寄 龍太 大屋 祐輔 國場 和仁 崎間 洋邦 山城 貴之 普久原 朝規 宮城 朋 波平 幸裕 城間 加奈子 石原 聡

出版者

一般社団法人日本脳神経超音波学会

雑誌

Neurosonology: 神経超音波医学 (ISSN:0917074X)

巻号頁・発行日

vol.31, no.2, pp.47-50, 2018

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We report two cases of stroke with calcified cerebral emboli (CCE). Case 1 was a 76 years old woman who experienced stroke with right hemiplegia. Non-contrast enhanced cranial computed tomography (CT) and magnetic resonance imaging on admission showed acute stroke and CCE in the branches of the left middle cerebral artery (MCA). A calcified plaque was seen as mitral annular calcification (MAC) on echocardiography. No other plaque was seen on echo and CT, so we identified MAC as the source of the emboli. Case 2 was 92 years old woman who experienced stroke with right hemiplegia and disturbance of consciousness. Non-contrast enhanced CT showed acute stroke and CCE in the branches of the MCA and a chest CT showed aortic arch calcification. We identified as aortic arch calcification as the source of the emboli. In these cases, ultrasound examination and CT were useful for the diagnosis of CCE. Since CCE is difficult to diagnose, further investigations are recommended.

著者

堀尾 欣伸 竹本 光一郎 古賀 嵩久 河野 大 保田 宗紀 佐原 範之 高木 勇人 嶋田 裕史 阪元 政三郎 井上 亨

出版者

一般社団法人日本脳神経超音波学会

雑誌

Neurosonology: 神経超音波医学

巻号頁・発行日

vol.30, no.3, pp.144-147, 2017

被引用文献数

2

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A 79-year-old woman was admitted to our hospital with vertigo. Vertigo was exacerbated by head rotation. Head magnetic resonance imaging revealed no acute cerebral infarction. The bilateral posterior communicating artery was not seen on magnetic resonance angiography. Three-dimensional computed tomographic angiography revealed severe stenosis in the left subclavian artery. Carotid Doppler ultrasonography (CDUS) revealed a change in the vertebral artery (VA) blood flow with the head rotated. These findings were also confirmed using dynamic digital subtraction angiography (DSA). Stenting in the left subclavian artery was performed, and the vertigo disappeared. This is the first report of subclavian steal syndrome that appeared with head rotation. These findings suggest that evaluation of VA and subclavian artery using dynamic CDUS and DSA is required for patients presenting with vertebrobasilar insufficiency even if VA blood flow is antegrade in the neutral position.