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A 63-year-old man suffered from recurrent transient ischemic attacks. Duplex sonography showed a small echogenic plaque at the right carotid bifurcation.During transcranial Doppler studies with a reverberating compression maneuver of the right common carotid artery low in the neck, multiple emboli signals were detected,and the patient developed a left- sided hemiparesis with slurred speech.Funduscopy revealed cholesterol emboli in the inferior temporal anteriole of the right eye.These findings suggested embolization as the cause of the stroke.Compression maneuvers should not be performed in patients with recent neurological symptoms,even in the case of only small lesions in the extracranial carotid territory. |
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