• Jinbo Huang, Hailing Liu, Hai Chen, Li Yuan, Ling Fang, and Zhi Yang.
• Department of Neurology, Maoming People's Hospital, Maoming, Guangdong, China.
• World Neurosurg. 2020 Sep 1; 141: 149-152.

BackgroundAcute bilateral internal carotid artery (ICA) occlusion has rarely been reported to exhibit an improvement in prognosis. Herein, we report a case of acute bilateral ICA occlusion presenting with bilateral symmetric cortical and basal-ganglia infarctions that exhibited dramatic improvement after a mechanical thrombectomy.Case DescriptionThe patient was a 72-year-old man with a history of hypertension who presented with a coma and quadriplegia during sleep and experienced moderate vomiting and diarrhea the day before admission to our hospital. Neurologic examination revealed that the patient was in a coma (National Institutes of Health Stroke Scale 35). A brain computed tomography (CT) scan showed a hypodense lesion in the bilateral frontal cortex. An emergency cerebral angiography demonstrated complete occlusion of the bilateral ICA. Subsequently, a mechanical thrombectomy of the bilateral ICA was successfully performed. At a 3-month follow-up, the patient had residual slight aphasia and quadriparesis (National Institutes of Health Stroke Scale 16).ConclusionsBilateral ICA occlusion should be considered if a patient presents with a coma, quadriplegia, and symmetric cortical infarctions. In such a case, a bilateral mechanical thrombectomy may represent a potential treatment for improving the prognosis of the affected patient.Copyright © 2020 Elsevier Inc. All rights reserved.

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