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Top of the Carotid/Carotid T Occlusions

Learning objectives

  • Learning
  • Understand
  • Integrate
  • Reflect

  • Top of the carotid at its bifurcation into ACA and MCA often called the carotid T
  • The shape of the lumen is T is filled with clot - ICA/MCA/ACA
  • Often embolic e.g. AF
  • Artery to artery from carotid thrombus - atherosclerosis or dissection
  • Other cardioembolic causes
  • Left ventricular thrombus formation after acute myocardial infarction
  • Cryptogenic stroke
  • ACA stroke syndrome
  • MCA stroke syndrome

  • CT may show dense artery +/- evolved stroke
  • MRI/A and CTA may show the occlusion
  • Aetiology: ECG, Echo, 24/48/7 day tape for AF
  • Acute stroke care and reperfusion therapy - Thrombolysis and Thrombectomy
  • Admit HASU. See Hyperacute care.