MASSIVE CEREBRAL INFARCTION - A POTENTIAL FATAL COMPLICATION OF PLAQUE FISSURING OF LIPID-RICH ATHEROMAS OF THE CAROTID-ARTERY - CASE-REPORTS

The authors report 2 patients who died of massive cerebral infarction secondary to plaque fissuring of and hemorrhage into their carotid ath eromas, resulting in overlying thrombosis and total occlusion of the i nternal carotid arteries. In both cases, the atheromas caused more tha n 75% reduction in luminal size of the carotid artery. In addition, th ey were rich in lipid content, which accounted for more than 40% of th e cross-sectional area of the atheromatous plaques. It is postulated t hat high-grade stenotic carotid atheromatous plaques with a high lipid content are at an increased risk of giving rise to subsequent neurolo gic complications, including massive cerebral infarction, as exemplifi ed by the present 2 reported cases.