UMMS Affiliation

Department of Surgery, Division of Vascular and Endovascular Surgery; School of Medicine; Senior Scholars Program

Publication Date


Document Type



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://

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/Book/Conference Title

Journal of vascular surgery cases and innovative techniques


Colleen Flanagan participated in this study as a medical student in the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.