[The aortic arch as an embolism source for cerebral infarcts]

Fortschr Neurol Psychiatr. 1996 Sep;64(9):367-74. doi: 10.1055/s-2007-996580.
[Article in German]

Abstract

Atherosclerotic plaques in the aortic arch are a potential source of cerebral emboli in patients with cryptogenic stroke (Amarenco et al., 1994). We report on seven patients with cerebral infarction, who had atherosclerotic plaques in the aortic arch, diagnosed by transesophageal echocardiography (TEE). Cardiovascular risk factors as hypertension, diabetes, hypercholesterolemia or cigarette smoking were found in all cases. Carotid disease was present in four patients, one patient had atrial fibrillation with left atrial spontaneous echo contrast, which might have been an additional potential embolic source. Intraluminal protrusion of the plaques ranged from five to twenty-four millimeters. In conclusion, even in patients with carotid or heart disease, the aortic arch may be an important source of cerebral emboli. In cases with mobile and pedunculated protruding atheromas anticoagulation should be considered.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Aorta, Thoracic* / diagnostic imaging
  • Aortic Diseases / complications*
  • Aortic Diseases / diagnostic imaging
  • Arteriosclerosis / complications*
  • Arteriosclerosis / diagnostic imaging
  • Echocardiography, Transesophageal
  • Female
  • Humans
  • Intracranial Embolism and Thrombosis / diagnostic imaging
  • Intracranial Embolism and Thrombosis / etiology*
  • Male
  • Middle Aged
  • Risk Factors

Substances

  • Anticoagulants