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Images in Neurology
June 2003

Iatrogenic Neurology: A Wire in the Carotid Artery

Arch Neurol. 2003;60(6):896-897. doi:10.1001/archneur.60.6.896

A 38-YEAR-OLD man was admitted to the hospital with sudden onset of left hemiparesis. A diagnosis of right middle cerebral artery stroke was established. His medical history was significant for a right parietal arteriovenous malformation, which had been treated by an endovascular procedure about 8 years previously.

As part of the stroke workup, the patient underwent carotid Doppler ultrasound. The ultrasound showed a linear hyperechoic signal throughout the length of the right internal carotid artery (Figure 1). The flow was normal. The abnormal signal was thought most likely due to a catheter or a foreign body in the internal carotid artery. A plain x-ray film of the neck and chest showed a wire extending from the thoracic aorta to the right internal carotid artery (Figure 2). On fluoroscopy, the wire could be traced from the rightfemoral artery through the abdominal aorta, thoracic aorta, right common–internal carotid artery, and middle cerebral artery to the right parietal region of the brain.

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