Case 9

Common carotid arteries arising from the aorta

This is a picture of the common carotid arteries arising from the aorta. The left internal carotid artery contains a thrombus just beyond the bifurcation of the left common carotid artery.

Question 1

Which are the following are true? (Tick all those that apply)

	a)	The thrombus is likely to have formed at a distant site and embolized here.
	b)	The thrombus overlies an atherosclerotic plaque.
	c)	Turbulent blood flow at this site predisposes to atherosclerosis.
	d)	Ultrasonography of the carotid arteries can quantify the extent of the stenosis caused by the thrombus.
Correct. This thrombus has formed in situ over an advanced complicated atherosclerotic plaque. Turbulent blood flow at the carotid bifurcation is a predisposing factor to the development of atherosclerosis. Carotid ultrasound is a quick, non-invasive imaging technique that can estimate the degree of the stenosis. Incorrect. This thrombus has formed in situ over an advanced complicated atherosclerotic plaque. Turbulent blood flow at the carotid bifurcation is a predisposing factor to the development of atherosclerosis. Carotid ultrasound is a quick, non-invasive imaging technique that can estimate the degree of the stenosis. Your answer has been saved.

Question 2

Which of the following statements are true? (Tick all those that apply)

	a)	Embolization of this thrombus could cause haemorrhagic stroke.
	b)	Embolization of this thrombus could cause transient ischaemic attack.
	c)	Embolization of this thrombus to the left middle cerebral artery would cause a left sided hemiparesis.
	d)	In situ thrombosis in the carotid arteries is more common than in situ thrombosis in the cerebral arteries.
Correct. Embolization of fragments of this thrombus may cause transient ischaemic attacks or a complete stroke due to cerebral infarction. Haemorrhagic strokes are caused usually caused by spontaneous intracerebral haemorrhages due to hypertension. Embolization to the left middle cerebral artery would cause a right hemiparesis. In situ thrombosis in the cerebral arteries is not common as in the carotid arteries because atherosclerosis affects the cerebral affects less frequently than the carotids. Page reference for both questions: 424-6 Incorrect. Embolization of fragments of this thrombus may cause transient ischaemic attacks or a complete stroke due to cerebral infarction. Haemorrhagic strokes are caused usually caused by spontaneous intracerebral haemorrhages due to hypertension. Embolization to the left middle cerebral artery would cause a right hemiparesis. In situ thrombosis in the cerebral arteries is not common as in the carotid arteries because atherosclerosis affects the cerebral affects less frequently than the carotids. Page reference for both questions: 424-6 Your answer has been saved.

Carton, Daly & Ramani: Clinical Pathology - Case Studies

Table of Contents

Case 9

Question 1

Question 2