Anyone similar to this: blockage m1 cerebral artery

Bobowens
Bobowenson Saturday, August 31 2024
1 Comment

Hi

      My 67 year old wife had had five episodes lasting no more than 10 minutes each. One was she could not talk correctly. These were from April to end of June and her annual visit with Dr was in late July. In June she was put on Lipitor unrelated to this as no one knew about her episodes.

         Today after her CT scan yesterday, her Lipitor was increased to 80

         In the past week, She has had MRI brain no contrast, MRAs of head and of carotid (neck) both no contrast and CTA neck/head with contrast She has blockages on M1 branch of the left middle cerebral artery and A1 branch of the left anterior cerebral artery

        Questions

  1. Does stent/angioplasty generally work for this?

From CT scan: FINDINGS:

        Small amount of calcified plaque present along the aortic arch without significant stenosis. Three arch branch vessels. Vertebral arteries appear widely patent. No evidence of vertebral artery dissection. Small amount of calcified plaque present along the proximal left internal carotid artery without significant stenosis. The left internal carotid artery is diffusely diminutive throughout the majority of its cervical segments without focal stenosis. Calcified plaque present at the carotid bulb and along the proximal right internal carotid artery causing less than 20 percent stenosis. Diffusely diminutive intracranial left internal carotid artery with marked stenosis of the supraclinoid portion of the left internal carotid artery. There is high-grade stenosis or occlusion of the M1 branch of the left middle cerebral artery with reconstitution of the more distal branches although markedly diminutive. High-grade stenosis or occlusion of the A1 branch of the left anterior cerebral artery with reconstitution of the A2 branch through the anterior communicating artery. Calcified plaque present along the cavernous portion of the right internal carotid artery causing less than 50 percent stenosis. Fenestration of the M1 branch of the right MCA. No focal occlusion or high-grade stenosis identified. More distal aspects of the M1 branch and M2 branches of the right MCA appear patent. Intracranial posterior circulation appears patent. No aneurysm identified. No abnormal intracranial enhancement. The visualized thyroid gland is unremarkable. No cervical mass or fluid collection.

Lung apices clear.

No acute fracture.

          IMPRESSION: 1. High-grade stenosis or occlusion of the M1 branch of the left MCA with diminutive reconstitution of the more distal branches of the left MCA. This is consistent with findings seen recent MRA of the neck. 2. Diffusely diminutive left internal carotid artery throughout the majority of its cervical and intracranial segments. 3. Approximately 50 percent stenosis of the cavernous segment of the right internal carotid artery.

1 Responses
StrokeLine avatar
StrokeLine

Hello Bobowens

 

 

Thanks for reaching out on EnableMe on behalf of your wife.  I am sorry to hear about her recent episodes. That sounds quite worrying for the both of you.

 

 

We are not medical here on StrokeLine, as our team are allied health professionals and cannot give medical advice.  Others within the community also cannot provide medical advice regarding what treatment will be appropriate for your wife, ie a stent/ angioplasty, but might share their own stories with you.  I would recommend your wife asking her GP for a referral to a cardiologist and asking the cardiologist your question of whether a stent/angioplasty would be appropriate for her.  Everyone is different and everyone has different comorbidities and medications. It is not safe to answer this online without review and from a medical practitioner.

 

 

Has your wife now let her Dr know about these episodes? If she hasn’t, I would suggest it is really important to mention these to her Dr, so that they know what has been happening for her.  These could be possible Transient Ischaemic Attacks (TIA’s) which have similar signs and symptoms to those of a stroke. If this hasn’t been mentioned to your wife, check in with her Dr and ask whether this might be a possible diagnosis for the events she has experienced since April.   

 

 

The most common signs of a TIA and stroke are the F.A.S.T signs (facial weakness or dropping, arm weakness and difficulty with speech).

 

You can check the FAST signs by asking the questions below.

 

  • Face: Check their face. Has their mouth drooped?

 

  • Arms: Can they lift both arms?

 

  • Speech: Is their speech slurred? Do they understand you?

 

  • Time: Is critical. If you see any of these signs, call 000 straight away.

 

 

These are not the only signs, so it is always good to be aware of the other signs of stroke and TIA. These may occur alone or in combination with the FAST signs:

 

  • Weakness or numbness or paralysis of the face, arm or leg on either or both sides of the body

 

  • Difficulty speaking or understanding

 

  • Dizziness, loss of balance or an unexplained fall

 

  • Loss of vision, sudden blurring or decreased vision in one or both eyes

 

  • Headache, usually severe and abrupt onset or unexplained change in the pattern of headaches

 

  • Difficulty swallowing

 

 

You can also read more about what a TIA is here. The important point here is that if you wife is experiencing any of these signs or symptoms, it is always a medical emergency, and you should call 000 (triple zero) so she can be medically reviewed as soon as possible.

 

 

It is great that your wife has undergone a CT scan and MRI, and that the Dr has increased her statin (the Lipitor) to 80mg. When there is too much cholesterol in the blood, it can build up on artery walls and narrow the arteries. It can block the flow of blood or cause blood clots, leading to an ischaemic stroke or TIA.

 

 

It can be tough trying to find the right treatment, especially after experiencing these events for a few months now, but it sounds like your wife is getting medical input from her Dr.  We here at StrokeLine are also here for you and your wife if you have questions about stroke and TIA signs or risk factors for stroke.  You are also welcome to give us a call here at StrokeLine to talk more about what you are going through.  You can give us a call on Ph 1800 787 653 or email us on strokeline@strokefoundation.org.au. We are open Monday to Friday 9am to 5pm AEST.

 

Kind regards

 

StrokeLine

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