Page 46 - Virtual Vascular Vol 14
P. 46
Bilateral Carotid Occlusion
A 67 year old gentleman with history of NPC with radiotherapy done more than 10
years ago. Presented with left arm and leg ‘shaking/trembling’ resembling partial
seizures.
Physical examination had normal 4 limb neurology and no cerebellar signs. In the
neck, there was evidence of post radiation therapy fibrosis. Right carotid pulse was
absent and no carotid bruit was heard bilaterally.
No abnormality was found on a plain CT brain. Ultrasound carotid duplex was done:
Right ICA reconstitution Carotid Duplex
>50% stenosis
R L
Left ICA occlusion
Right common carotid artery total occlusion Left common carotid artery patent
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