BACKGROUND AND PURPOSE: Cystic medionecrosis is characterized by degeneration of elastic and collagenous fibers in the media and predominantly involves the thoracic aorta. This rare disease is usually manifested clinically by a dissecting aneurysm. Cystic medionecrosis as a cause of moderate stenosis of the carotid artery in a patient having a stroke has not been reported. SUMMARY OF CASE: We report a case of a man who had a cerebral infarction caused by medium-degree stenosis of the left internal carotid artery. Duplex sonography and magnetic resonance imaging revealed no typical signs of dissection. The stenosis was caused by cystic medionecrosis that involved only the carotid bifurcation with microdissection, predominantly older intramural hemorrhage, and fresh intraluminal thrombotic deposits. CONCLUSIONS: Patients with cystic medionecrosis may have a stroke due to short-track stenosis of the internal carotid artery.
BACKGROUND AND PURPOSE: Cystic medionecrosis is characterized by degeneration of elastic and collagenous fibers in the media and predominantly involves the thoracic aorta. This rare disease is usually manifested clinically by a dissecting aneurysm. Cystic medionecrosis as a cause of moderate stenosis of the carotid artery in a patient having a stroke has not been reported. SUMMARY OF CASE: We report a case of a man who had a cerebral infarction caused by medium-degree stenosis of the left internal carotid artery. Duplex sonography and magnetic resonance imaging revealed no typical signs of dissection. The stenosis was caused by cystic medionecrosis that involved only the carotid bifurcation with microdissection, predominantly older intramural hemorrhage, and fresh intraluminal thrombotic deposits. CONCLUSIONS:Patients with cystic medionecrosis may have a stroke due to short-track stenosis of the internal carotid artery.