My 80 year old grandmother had an episode 2 days ago where her right arm went numb for 5 hours. Her doctor had an MRI done as well as a carotid scan. The results (MRI) say: 1) Three punctate areas of acute infarction left parietal lobe. Multifocality concerning embolic disease. 2) Diffuse cerebral atrophy with ventriculomegaly. 3) Chronic posterior right parietal/occipital infarction. 4) Increased T2/FLAIR signal in the para ventricular and deep white matter is non-specific but most likely due to chronic small vessel ischemic change/chronic lacunar infarctions.
Results for Carotid scan say: 1) Severe stenosis (75%-99%) of the origin of the left internal carotid artery. 2) Widely patent right common and internal carotid arteries. 3) Severe stenosis/near complete occlusion of the origin of the right vertebral artery.
What does all this mean and is there anything that can be done? I would like a better understanding before I take her to a vascular surgeon next week.
The MRI report describes foci of chronic and acute infarcts (dead tissue causes by reduced blood supply), secondary to emboli (intravascular mass) causing blockade of the vasculature/ blood supply to the region.
The carotid scan describes severe blockade of the left internal carotid artery (one of the four arteries supplying the brain), which is the likely reason for embolic infarcts. With 75-99% blockade, a carotid endarterectomy would typically be advised. Though the symptoms may not improve with the procedure, this would be required to prevent future episodes. Also endarterectomy cannot be done if the blockade is 100%. I would suggest consulting a vascular surgeon in addition to a neurologist for a detailed evaluation and suggestion of an appropriate management plan.
Hope this is helpful.
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