Thrombus in the Kommerell’s diverticulum as a suspected cause of stroke in a very elderly patient: a case report

DOI Web Site 7 References Open Access
  • Mito Daiki
    Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center
  • Matsuoka Mikiaki
    Cerebrovascular and Neurology Center, National Hospital Organization Fukuoka Higashi Medical Center
  • Kiyohara Takuya
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Yubi Tomohiro
    Department of Cerebrovascular Medicine, Hakujuji Hospital
  • Kumai Yasuhiro
    Department of Cerebrovascular Medicine, Hakujuji Hospital
  • Sugimori Hiroshi
    Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center

Bibliographic Information

Other Title
  • Kommerell憩室内の血栓による脳梗塞が疑われた超高齢患者の1例

Search this article

Description

<p>A 90-year-old woman, being treated with apixaban for chronic atrial fibrillation, was transferred to our hospital with consciousness disturbance and right hemiplegia. Head MRI/A revealed acute cerebral infarction in the whole territory of the left posterior cerebral artery and occlusion at the P1 segment of the artery. Chest roentgenogram showed the right-sided aortic arch and the following contrast-enhanced CT revealed a Kommerell’s diverticulum (KD) complicated with aberrant left subclavian artery. From the filling defect in the diverticulum, we suspected that the thrombus in the KD was the cause of the embolic cerebral infarction. KD is a congenital malformation formed in the process of aortic arch formation and is often found incidentally when searching concomitant anomaly of the right-sided aortic arch. When KD causes symptoms due to its expansion and compression to adjacent organs, it eventually leads to fatal complications, rupture or dissection, and swift surgical repair is recommended. Although cerebral complications may occur secondary to rupture or dissection, ischemic stroke due to thrombus in the KD has not been reported. We present a very rare case of high-aged cerebral infarction caused by KD and treated with another direct oral anticoagulant, rivaroxaban.</p>

Journal

References(7)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top