Thrombus of the Ascending Aorta as a Source of Cerebral Embolism

Brain Embolism Caused by a Mobile Aortic Thrombus with Iron Deficiency Anemia

“…In previous studies, embolic stroke associated with an MTAA usually showed atherosclerotic changes at the origin of the MTAA [2][3][4][5] . Therefore, it seems that atherosclerosis plays a major role in the formation of a mobile thrombus at the aortic arch.…”

“…However, in those studies, an MTAA was detected in a small number of cases without identifi able atherosclerotic changes in the aorta [4,5] . There are scattered reports of various conditions other than atherosclerotic changes that may predispose to intra-aortic thrombosis, such as thrombocythemia [8] , polycythemia [9] , antithrombin III defi ciency [10] , protein C defi ciency [4] , antiphospholipid antibody syndrome [4] , malignant tumor [2] , blunt chest trauma [11] , chest gunshot wound [12] or systemic fungal infection [13] . (However, these abnormalities were not seen in the present cases.)…”

“…The patient met all qualifying criteria for intravenous tissue plasminogen activator (IV t-PA). Although she was of advanced age, her severe stroke and good premorbid functioning as well as studies suggesting that the risks and benefi ts of intravenous t-PA in ischemic stroke patients aged 6 80 years, are comparable to those in younger individuals when administered according to established protocols [2][3][4] , she was given IV t-PA according to the NINDS protocol [5] .…”

“…She had mild Atherosclerotic lesions at the aortic arch are recognized as potential sources of embolic stroke [1] . There were some reports of embolic stroke caused by a mobile thrombus located at the aortic arch (MTAA) [2][3][4][5] . Although almost all these patients had marked atherosclerotic changes, a few reports demonstrated that an MTAA was not accompanied by atherosclerotic changes and had no definite etiology [4,5] .…”

Characterization of ultrasound‐detected cerebral microemboli in patients undergoing cardiac catheterization using an in vitro middle cerebral artery model

“…The occurrence of this complication was reported to vary from 0.08% to 0.15% [13,16]. It has been suggested that atherosclerotic plaque in the carotid arteries can produce emboli by two mechanisms, by the rupture of its contents into the blood stream and by the breaking off of a thrombus formed on an ulcerated surface or in the blood stream when flow distal to the plaque is slowed [38,39]. In these cases, the dislodgment may be triggered either by catheter manipulation or by the pressurized jet of contrast material [11].…”