AORTIC-ARCH AS A SOURCE OF CEREBRAL EMBOL I

Atherosclerotic plaques in the aortic arch are a potential source of c erebral emboli in patients with cryptogenic stroke (Amarenco et al., 1 994). We report on seven patients with cerebral infarction, who had at herosclerotic plaques in the aortic arch, diagnosed by transesophageal echocardiography (TEE). Cardiovascular risk factors as hypertension, diabetes, hypercholesterolemia or cigarette smoking were found in all cases. Carotid disease was present in four patients, one patient had a trial fibrillation with left atrial spontaneous echo contrast, which m ight have been an additional potential embolic source. Intraluminal pr otrusion of the plaques ranged from five to twenty-four millimeters. I n conclusion, even in patients with carotid or heart disease, the aort ic arch may be an important source of cerebral emboli. In cases with m obile and pedunculated protruding atheromas anticoagulation should be considered.