[Skip to Navigation]
Sign In
Views 796
Citations 0
JAMA Surgery Clinical Challenge
January 2015

Symptomatic Carotid Stenosis

Author Affiliations
  • 1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Emory University, Atlanta, Georgia
JAMA Surg. 2015;150(1):79-80. doi:10.1001/jamasurg.2014.376

A woman in her early 60s with a history of hypertension and hyperlipidemia was transferred to our hospital after multiple transient ischemic attacks and left internal carotid artery (ICA) stenosis during the past several months. Her most recent presentation was 1 week prior for a minor stroke with amaurosis fugax, slurred speech, right-sided weakness, and facial droop lasting longer than 24 hours. Magnetic resonance imaging of the brain demonstrated subacute infarctions involving the left frontal and parietal hemispheres. She was a current smoker and was taking aspirin and statin medication at the time of presentation. Workup at another facility prior to transfer included computed tomographic angiography of the neck, which showed chronic occlusion of the right ICA and 95% stenosis of the left ICA.

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    1 Comment for this article
    Health care strategies
    J. Geren Nichols, MD | TPMG Fresno, CA
    The first episode this patient had should have been considered a neurologic emergency and a greater improvement in health care would be achieved if that is recognized in the future than learning the rather exotic images and radiographic techniques presented here.