A Case of Internal Carotid Artery Stenosis with Discontinuance of Carotid Endarterectomy due to the Tight Adhesions around the Internal Carotid Artery Ryusuke KOHRI 1 , Masayuki MIYAZONO 1 , Ryusuke HATAE 1 , Kazushi MAEDA 1 , Asuka TAKAHIRA 2 , Yasuhiro MAEDA 2 , Takamitsu MIZOTA 2 , Shinji NAITO 3 1Department of Neurosurgery,National Hospital Organization,Ureshino Medical Center 2Department of Neurology,National Hospital Organization,Ureshino Medical Center 3Department of Pathology,National Hospital Organization,Ureshino Medical Center Keyword: carotid endarterectomy , cholesteatoma , parapharyngeal space , carotid space pp.445-450
Published Date 2012/5/10
DOI https://doi.org/10.11477/mf.1436101728
  • Abstract
  • Look Inside
  • Reference

 A 73-year-old female visited her local doctor after repeatedly experiencing temporary weakness in her left upper and lower extremities. The patient underwent a cervical magnetic resonance imaging (MRI) scan and was diagnosed with right internal carotid artery stenosis. Despite administration of antiplatelet drugs,her symptoms continued,and she was referred to our department for medical treatment. Her medical history revealed hypertension,hyperlipidemia,and cholesteatoma. We diagnosed symptomatic internal carotid artery stenosis and performed carotid endarterectomy (CEA). However,tight adhesions between the carotid artery and surrounding tissue made separation difficult,and surgery had to be discontinued. Some of the extracted adherent tissue consisted of hyalinized fibrous tissue that had the appearance of soft tissue which had organized because of inflammation. Although there have been no reports of cholesteatoma directly causing adhesion around the internal carotid artery,it has been reported to have led to abscess formation in the parapharyngeal space adjacent to the carotid space. Because the boundaries of the parapharyngeal space and carotid space are anatomically incomplete,inflammation often affects the area between them. As far as we know,this report,which also includes a discussion of the literature,is the first to indicate that cholesteatoma causes strong adhesions around the carotid artery.

Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院