coomon carotid occlusion is a very rare condition. I present a case of a male discovered with common carotid occulsion in an asimptomatic state

1. Ocluzie ACC bilaterala la un
pacient asimptomatic
neurologic
Alexandru Andritoiu
Sp. Militar Craiova

2. Caz clinic
S. Alexandru, 55 ani
• fara acuze neurologice
Aug. 2013
- descoperit la un examen Eco-Doppler
cu ocluzie bilaterala ACC

3. Ex clinicEx clinic
• Echilibrat CV:
TA 135/85 mmHg, FC 70/min
• Consult neurologic
,,Frust sdr. piramidal dr (schita Babinski)

4. Profilul biochimicProfilul biochimic

5. RMN Craniu

6. US Doppler CARUS Doppler CAR
ACC dreapta
ACC stanga

7. Doppler-aa VertebraleDoppler-aa Vertebrale
AV dreapta AV stanga
Supleere prin magistralele vertebrale

8. Doppler aa. oftalmiceDoppler aa. oftalmice
A. Oftalmica stangaA. Oftalmica dreapta

9. A. oftalmica
CDI observations in the four types of
circulation.
Normal = normal circulation in patients without
ICAO;
Type 1 = forward OA, CRA, and SPCA flow;
Type 2a = reverse OA and forward CRA and
SPCA flow;
Type 2b = reverse OA and undetectable CRA
and SPCA flow;
Type 3 = undetectable OA, CRA, and SPCA
flow.

10. The 4 patterns of collateral flow via the circle of Willis to the hemisphere ipsilateral to
the symptomatic ICA occlusion. PCoA indicates posterior communicating artery.
Pattern of flow via the OphA ipsilateral to the symptomatic occluded ICA in patients with a
symptomatic ICA occlusion 0 to 6 months, 6 to 12 months, and 12 to 18 months after
symptoms occurred. Left, Patients with a unilateral ICA occlusion (n=41). Right, Patients
with a bilateral ICA occlusion (n=21).
Rutgers D et al.- Stroke 2000

11. Ce spune literatura medicalaCe spune literatura medicala
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16. ConcluziiConcluzii
• Ocluzia ACC este rara si se insoteste de obicei de infarct
cerebral intins la nivelul emisferului homolateral
• Ocluzia ACC/ACI bilaterala este (teoretic) incompatibila
cu viata
• Rata anuala de stroke in ocluzia bilaterala ACI: 0-13%
• Cazul nostru demonstreaza posibilitatea supravietuirii in
absenta unui stroke fatal, gratie rolului circulatiei
colaterale functionale
• Ocluzia carotidiana bilaterala-un stimul al preconditionarii
ischemice cerebrale in prevenirea leziunilor ischemice
focale