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The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion

Background and Objectives: Carotid revascularization is one of the most effective treatment options in patients with severe carotid artery stenosis causing hypoperfusion in basal ganglia. Atypical manifestations include hyperkinetic movements, noted as extremely rare. We report a case about a patien...

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Autores principales: Strautmane, Sintija, Priede, Zanda, Millers, Andrejs
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9607088/
https://www.ncbi.nlm.nih.gov/pubmed/36295488
http://dx.doi.org/10.3390/medicina58101328
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author Strautmane, Sintija
Priede, Zanda
Millers, Andrejs
author_facet Strautmane, Sintija
Priede, Zanda
Millers, Andrejs
author_sort Strautmane, Sintija
collection PubMed
description Background and Objectives: Carotid revascularization is one of the most effective treatment options in patients with severe carotid artery stenosis causing hypoperfusion in basal ganglia. Atypical manifestations include hyperkinetic movements, noted as extremely rare. We report a case about a patient with 2-months-long complaints of Uncontrollable movements in his right side of the body subsided after carotid revascularization. Case presentation: A 71-year-old male was admitted to Pauls Stradins Clinical University Hospital with the main complaints of 2-months-long uncontrollable movements in his right hand and his right leg. When performing coordination tasks, slight inaccuracy was noted with the right-side extremities. Hyperkinetic movements—choreoathetosis in the right side of the patient’s face, arm, and leg—were seen. Computed tomography angiography revealed subocclusion in the proximal segment of the left internal carotid artery and 30% stenosis in the proximal segment of the right internal carotid artery. The patient was consulted by a vascular surgeon. Eversion endarterectomy of the left internal carotid artery was performed. The early postoperative period occurred without complications. The patient was discharged from the hospital 2 days after the surgery in good overall health condition. Two months later, choreoathetotic movements in his right side of the body had markedly decreased. No focal neurologic deficits were noted. Conclusions: Revascularization may be effective by eliminating emboli and stenosis, leading to hypoperfusion in watershed territories. A case of a 71-year-old male patient with the main complaints of 2-months-long uncontrollable movements in his right side of the body subsiding after carotid revascularization was demonstrated. It is vital to recognize atypical manifestations of hypoperfusion, associated with stenosis in internal carotid arteries, to early make a diagnosis, to perform an appropriate treatment, and to reduce the risk of cerebral infarction in the future, resulting in a longer high-quality life for the patient.
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spelling pubmed-96070882022-10-28 The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion Strautmane, Sintija Priede, Zanda Millers, Andrejs Medicina (Kaunas) Case Report Background and Objectives: Carotid revascularization is one of the most effective treatment options in patients with severe carotid artery stenosis causing hypoperfusion in basal ganglia. Atypical manifestations include hyperkinetic movements, noted as extremely rare. We report a case about a patient with 2-months-long complaints of Uncontrollable movements in his right side of the body subsided after carotid revascularization. Case presentation: A 71-year-old male was admitted to Pauls Stradins Clinical University Hospital with the main complaints of 2-months-long uncontrollable movements in his right hand and his right leg. When performing coordination tasks, slight inaccuracy was noted with the right-side extremities. Hyperkinetic movements—choreoathetosis in the right side of the patient’s face, arm, and leg—were seen. Computed tomography angiography revealed subocclusion in the proximal segment of the left internal carotid artery and 30% stenosis in the proximal segment of the right internal carotid artery. The patient was consulted by a vascular surgeon. Eversion endarterectomy of the left internal carotid artery was performed. The early postoperative period occurred without complications. The patient was discharged from the hospital 2 days after the surgery in good overall health condition. Two months later, choreoathetotic movements in his right side of the body had markedly decreased. No focal neurologic deficits were noted. Conclusions: Revascularization may be effective by eliminating emboli and stenosis, leading to hypoperfusion in watershed territories. A case of a 71-year-old male patient with the main complaints of 2-months-long uncontrollable movements in his right side of the body subsiding after carotid revascularization was demonstrated. It is vital to recognize atypical manifestations of hypoperfusion, associated with stenosis in internal carotid arteries, to early make a diagnosis, to perform an appropriate treatment, and to reduce the risk of cerebral infarction in the future, resulting in a longer high-quality life for the patient. MDPI 2022-09-22 /pmc/articles/PMC9607088/ /pubmed/36295488 http://dx.doi.org/10.3390/medicina58101328 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Strautmane, Sintija
Priede, Zanda
Millers, Andrejs
The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion
title The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion
title_full The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion
title_fullStr The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion
title_full_unstemmed The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion
title_short The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion
title_sort impact of revascularization in a patient with atypical manifestations of hypoperfusion
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9607088/
https://www.ncbi.nlm.nih.gov/pubmed/36295488
http://dx.doi.org/10.3390/medicina58101328
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