Double or nothing: red flag symptoms of critical carotid stenosis, a case report

José Carlos Morán-Sánchez,José C Gómez-Sánchez,Yasmina El Berdei,María E Ramos-Araque,Irene Gómez-Estévez

doi:10.1186/s12883-017-0849-7

Double or nothing: red flag symptoms of critical carotid stenosis, a case report

José Carlos Morán-Sánchez, José C Gómez-Sánchez + Show 3 more

Open Access

https://doi.org/10.1186/s12883-017-0849-7

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Journal: BMC Neurology	Publication Date: Apr 5, 2017
Citations: 1	License type: open-access

Affiliation: Universidad de Salamanca

Abstract

BackgroundDetailed knowledge of every possible manifestation of Internal Carotid Artery (ICA) disease is important. For improving detection and a timely adoption of secondary prevention procedures or treatments. Transient oculomotor nerve palsies have been described associated with stenosis or occlusion of the ICA.Case presentationWe described a patient that develop a sequential combination of transient monocular loss of vision followed by binocular diplopia secondary to an unstable atherosclerotic preocclusive stenosis of an internal carotid artery previously treated with radiotherapy.ConclusionsThe peculiar sequence of transient monocular vision that give rise later into a transient binocular diplopia (double or nothing) should be kept in mind as a possible manifestation of critical stenosis of ICA.

Highlights

Detailed knowledge of every possible manifestation of Internal Carotid Artery (ICA) disease is important
Spain 2Institute of Biomedical Research of Salamanca, University Hospital of Salamanca, Salamanca, Spain patient with a sequential combination of transient loss of monocular vision immediately followed by binocular diplopia, as an atypical form of presentation of ICA stenosis, which could be named “double or nothing”
Cranial magnetic resonance (MR) and MR angiography of the supra-aortic trunks showed an acute infarct on the left lentiform nucleus (Fig. 1), as well as a 95% and 60% stenosis of the left and right ICA respectively

Summary

Introduction

Detailed knowledge of every possible manifestation of Internal Carotid Artery (ICA) disease is important. Internal carotid artery (ICA) stenosis usually gives rise to brain ischemic disease, ocular ischemic disease or both. In the past few years, several clinical cases of binocular diplopia caused by oculomotor nerve palsies have been described associated with stenosis or occlusion of the ICA [2, 3].

Results

Conclusion