Department of Surgery, Division of Vascular and Endovascular Surgery; School of Medicine
Cardiovascular Diseases | Nervous System Diseases | Surgery | Surgical Procedures, Operative
Carotid artery stenosis typically causes hemispheric neurologic effects by atheroembolism. Nonhemispheric symptoms, such as syncope, are generally not attributable to extracranial carotid disease. This report describes a 62-year-old woman with severe bilateral carotid artery stenosis, right vertebral artery occlusion, and severe left vertebral artery stenosis who presented with transient loss of consciousness and unilateral weakness when upright. Her symptoms resolved after right carotid endarterectomy. Whereas vertebrobasilar insufficiency alone can cause syncope, in the case of severe multivessel cerebrovascular disease, unilateral carotid revascularization was successful in treating the patient's transient loss of consciousness, suggesting global cerebral hypoperfusion as the cause.
Carotid stenosis, Hypoperfusion, Positional, Vertebrobasilar
Rights and Permissions
Copyright 2019 The Authors. Published by Elsevier Inc. on behalf of Society for Vascular Surgery. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
DOI of Published Version
J Vasc Surg Cases Innov Tech. 2019 Nov 9;5(4):461-466. doi: 10.1016/j.jvscit.2019.09.001. eCollection 2019 Dec. Link to article on publisher's site
Journal of vascular surgery cases and innovative techniques
Flanagan CP, Sheth PD, Simons JP. (2019). Positional transient loss of consciousness and hemispheric deficits in the setting of severe four-vessel extracranial cerebrovascular disease. Open Access Articles. https://doi.org/10.1016/j.jvscit.2019.09.001. Retrieved from https://escholarship.umassmed.edu/oapubs/4064
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.