SUMMARY OF BACKGROUND DATA: A 74-year-old man suffered an extensive right hemispheric infarct 72 hours after undergoing anterior corpectomies of the C4 and C5 vertebrae for cervical myelopathy resulting from ossification of the posterior longitudinal ligament. RESULTS: Angiography revealed proximal right internal carotid artery thrombosis with atherosclerosis and a normal left internal carotid artery. The thrombosis may have been due to stasis during lengthy retraction of an atherosclerotic carotid artery. CONCLUSIONS: Preoperative screening of internal carotid artery blood flow with Doppler ultrasonography is recommended before contemplating extensive anterior cervical surgery in middle-aged and elderly patients at significant risk for atherosclerotic disease.
SUMMARY OF BACKGROUND DATA: A 74-year-old man suffered an extensive right hemispheric infarct 72 hours after undergoing anterior corpectomies of the C4 and C5 vertebrae for cervical myelopathy resulting from ossification of the posterior longitudinal ligament. RESULTS: Angiography revealed proximal right internal carotid artery thrombosis with atherosclerosis and a normal left internal carotid artery. The thrombosis may have been due to stasis during lengthy retraction of an atherosclerotic carotid artery. CONCLUSIONS: Preoperative screening of internal carotid artery blood flow with Doppler ultrasonography is recommended before contemplating extensive anterior cervical surgery in middle-aged and elderly patients at significant risk for atherosclerotic disease.
Authors: Roger Härtl; Marjan Alimi; Mohamed Abdelatif Boukebir; Connor D Berlin; Rodrigo Navarro-Ramirez; Paul M Arnold; Michael G Fehlings; Thomas E Mroz; K Daniel Riew Journal: Global Spine J Date: 2017-04-01