Secondary thrombosis of the left internal carotid artery caused by a motor vehicle accident: a radiological case

Goda Randakevičienė¹, Rymantė Gleiznienė¹, Daiva Rastenytė², Saulius Lukoševičius¹

¹Department of Radiology, Kaunas University of Medicine, ²Department of Neurology, Kaunas University of Medicine, Lithuania

Key words: internal carotid occlusion; computed tomography; craniotomy; rehabilitation.

Summary. A rare case of occlusion of the internal carotid artery following a motor vehicle accident in a 34-year-old female victim who initially presented with clear consciousness and had normal computed tomogram of the brain is reported. Seven hours after the accident, the patient was unexpectedly diagnosed with the left hemisphere infarction, and two days later, she suffered from right hemiplegia and coma. The follow-up brain computed tomography scan showed an acute infarction of the left hemisphere of the cerebrum and severe cerebral edema. Anticoagulation therapy was administered, and emergency craniotomy for brain decompression was carried out. After 3.5 months, she was discharged and underwent regular follow-up in the outpatient department. Four years after the motor vehicle accident, the patient had intact awareness, was functionally independent, but remained with motor aphasia, right hand paralysis, and right leg paresis.

Correspondence to R. Gleiznienė, Department of Radiology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: rymangleiz@gmail.com

Received 1 April 2009, accepted 6 April 2010