case_images: PMC10999126_01
case_images: An axial view of the contrast-enhanced CT scan showed a right middle cerebral artery territory basal ganglia infarction involving the caudate nucleus and cortical region, which is a large, poorly defined hypodensity, as indicated by the arrow.. CT: computed tomography.
case_images: 10.1177_2050313X241241190-fig1.jpg
case_images: PMC10999126_01_10.1177_2050313X241241190-fig1.jpg
case_images: fig1-2050313X241241190
case_images: A contrast brain computed tomography (CT) scan showed ischemic infarction (Figure 1).
case_images: (a) B-mode transverse view of carotid artery Doppler ultrasound showed moderately echoic circumferential arterial wall thickening and completely occluded right carotid artery with echogenic intraluminal focus, demonstrating the "macaroni sign" as indicated by the black arrows. (b) B-mode longitudinal view of right carotid artery Doppler ultrasound showed long, smooth, homogeneous, and relatively echoic circumferential thickening of the arterial wall, indicated by the white arrows, and completely occluded with echogenic intraluminal focus, as indicated by the black arrow.. JV: jugular vein; CCA: common carotid artery; Tyr: thyroid gland; CA: carotid artery; CIMT: carotid intimal medial thickness.
case_images: 10.1177_2050313X241241190-fig2.jpg
case_images: PMC10999126_01_10.1177_2050313X241241190-fig2.jpg
case_images: fig2-2050313X241241190
case_images: Doppler ultrasound of the neck showed circumferential thickening of the carotid arterial wall with luminal narrowing and completely occluded with echogenic intraluminal focus and absent Doppler flow (Figure 2(a) and (b)).
case_images: (a) CTA showed (1) long segment occlusion of bilateral CCA. (2) Occlusion of the cervical and intracranial segment of bilateral ICA with thickened enhancing wall. (3) Long segment occlusion with significant smooth luminal stenosis of the LSCA (9.1 cm), proximal and distal RSCA measuring 2.5 cm and 5.6 cm in length, respectively. (4) Left proximal AA long segment occlusion measuring 9.1 cm in length; (5) LBA long segment significant luminal narrowing with thickened and enhancing wall measuring 14.9 cm in length. (6) BCA luminal narrowing with thickened enhancing wall, as indicated by the arrows. (b) An axial view of the CTA showed a typical aortic arch and descending thoracic aorta concentric wall thickening, as indicated by the arrow.. RCCA/LCCA: right/left common carotid artery; RICA/LICA: right/left internal carotid artery; BCA: brachiocephalic artery; LSCA/RSCA: left/right subclavian artery; LAA: left axillary artery; LBA: left brachial artery; CTA: computed tomography angiography.
case_images: 10.1177_2050313X241241190-fig3.jpg
case_images: PMC10999126_01_10.1177_2050313X241241190-fig3.jpg
case_images: fig3-2050313X241241190
case_images: She underwent CT angiography (CTA) by 2023 and showed enhancing aortic wall thickening and multiple aortic arch branch obstructive diseases (Figure 3(a) and (b)).