Calcified cerebral emboli associated with calcified carotid plaque: a case report and morphological consideration for plaque calcification

Acta Neurochir (Wien). 2024 Nov 4;166(1):439. doi: 10.1007/s00701-024-06339-w.

Abstract

We described a rare case of acute ischemic stroke due to calcified cerebral emboli from calcified carotid plaque (CCP). Radiological examinations revealed that the CCP had an irregular configuration containing a calcified nodule and scattered spotty calcifications, and a large calcified plate. The patient underwent carotid endarterectomy to prevent embolic recurrence. Histopathological examination confirmed the presence of an erupted plaque with a disrupted fibrous cap. Calcified nodular protrusion and spotty calcifications in CCP are predictive of a high risk of embolic stroke with plaque rupture. Thus, careful treatment strategies are crucial to prevent the CCP-related embolic recurrence.

Keywords: Calcified carotid plaque; Calcified cerebral emboli; Calcified nodule; Carotid endarterectomy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Calcinosis / diagnostic imaging
  • Calcinosis / pathology
  • Calcinosis / surgery
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / pathology
  • Carotid Artery Diseases / surgery
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / pathology
  • Carotid Stenosis / surgery
  • Endarterectomy, Carotid*
  • Female
  • Humans
  • Intracranial Embolism* / diagnostic imaging
  • Intracranial Embolism* / etiology
  • Intracranial Embolism* / pathology
  • Intracranial Embolism* / surgery
  • Male
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Plaque, Atherosclerotic* / pathology
  • Plaque, Atherosclerotic* / surgery
  • Vascular Calcification / complications
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / pathology
  • Vascular Calcification / surgery