UMMS Affiliation
Department of Surgery, Division of Vascular and Endovascular Surgery; School of Medicine; Senior Scholars Program
Publication Date
2019-11-09
Document Type
Article
Disciplines
Cardiovascular Diseases | Nervous System Diseases | Surgery | Surgical Procedures, Operative
Abstract
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.
Keywords
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
10.1016/j.jvscit.2019.09.001
Source
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
Related Resources
PubMed ID
31737804
Repository Citation
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 Publications by UMMS Authors. 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.
Included in
Cardiovascular Diseases Commons, Nervous System Diseases Commons, Surgery Commons, Surgical Procedures, Operative Commons
Comments
Colleen Flanagan participated in this study as a medical student in the Senior Scholars research program at the University of Massachusetts Medical School.