BILATERAL INTERNAL CAROTID-ARTERY DISEASE SECONDARY TO CERVICAL RADIATION - A CASE-REPORT

A patient with radiation-induced bilateral carotid artery disease is p resented. A fifty-six-year-old man was admitted to hospital for evalua tion of recurrent transient ischemic attacks. He had received cervical radiation for pharyngeal squamous cell. carcinoma five years earlier. The radiation was directed at the cervical fields bilaterally and the anterior cervical field using x-rays for a total of 120 Gy. Computed tomography of the brain obtained at admission revealed a low-density a rea in the right parietal lobe. Carotid arteriograms revealed a comple tely occluded right internal carotid artery and a severely narrowed le ft internal carotid artery. There was good collateral supply from the posterior communicating arteries to the internal carotid arteries, bil aterally. The patient was medically treated with anticoagulant and ant iplatelet therapy and has been free of subsequent cerebral ischemic at tacks.