Abstract
This case report aims to demonstrate the clinical significance of the left internal carotid artery (ICA) hypoplasia in a young woman who received a combined oral contraceptive (COC) and its association with arterial occlusion and the development of a lacunar stroke/lacunar cerebral infarct (LACI). Brain magnetic resonance imaging (MRI) of the left frontal lobe revealed multiple subcortical and periventricular amplification/ischemia foci (49.0×17.0 mm), and lacunar infarct loci (2.0×4.0 mm). Brain magnetic resonance angiography revealed a markedly narrowed lumen of the left ICA (2.0–3.0 mm). MRI diffusion-weighted imaging-fluid attenuated inversion recovery revealed a moderate diffuse wall thickening and reinforcement of the left ICA. The patient was diagnosed with LACI and congenital hypoplasia of the left ICA and underwent antiplatelet drug therapy (aspirin - 100 mg) and a complete withdrawal of COC. A full amelioration of neurological symptoms was observed after one month of treatment.
Highlights
Ischemic stroke/transient ischemic attack (TIA) remains a concern in neurology due to its wide prevalence, and high disability and mortality rates
Hormonal contraception increases blood viscosity, and the risk of TIA in smoking women over 30 years of age increases by 22-fold after OCP usage [7, 8]. This case report aims to demonstrate the clinical significance of the left internal carotid artery (ICA) in a young woman who received a combined oral contraceptive (COC), and its association with arterial occlusion and the development of lacunar cerebral infarct (LACI)
The patient was diagnosed with LACI and congenital hypoplasia of the left ICA and underwent an antiplatelet drug therapy and a complete withdrawal of COC
Summary
Ischemic stroke/transient ischemic attack (TIA) remains a concern in neurology due to its wide prevalence, and high disability and mortality rates. Hormonal contraception increases blood viscosity, and the risk of TIA in smoking women over 30 years of age increases by 22-fold after OCP usage [7, 8]. This case report aims to demonstrate the clinical significance of the left ICA in a young woman who received a combined oral contraceptive (COC), and its association with arterial occlusion and the development of LACI. She reported weakness and decrease of exteroceptive sensation in the right-hand, which increased a month prior One year prior, she took COCs (drospirenone 3 mg, ethinylestradiol 0.02 mg) to prevent an unwanted pregnancy. A full amelioration of neurological symptoms was observed after one month of treatment
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