Spontaneous Atheroembolism

Mark Bradley, M.D.

N Engl J Med 1995; 332:998April 13, 1995

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Figure 1 A 72-year-old man was admitted to the hospital with delirium, acute renal failure, increasing hypertension, sudden impairment of vision in the left eye, and severe pain in the left foot. Funduscopic examination of the left eye (Panel A) showed a cholesterol embolus, or Hollenhorst plaque (arrow), at the bifurcation of a retinal arteriole and vascular sheathing distal to the occlusion (arrowheads). No other physical findings were present. Distal pulses were palpable, but two toes later turned purple and one required amputation. Histologic examination of the amputated toe (Panel B) revealed an arteriole with characteristic needle-shaped clefts (arrow) resulting from atheroemboli. The patient had undergone no surgical or diagnostic procedures and had not received anticoagulants. Progressive renal failure developed one year later, and the patient died.

Kim Eagle, M.D.

Mark Bradley, M.D.
Roseburg Veterans Affairs Medical Center, Roseburg, OR 97470

Citing Articles (1)

Citing Articles

1
Kotaro Oe, Tsutomu Araki, Akikatsu Nakashima, Katsuaki Sato, Tetsuo Konno, Masakazu Yamagishi. (2010) Late Onset of Cholesterol Crystal Embolism after Thrombolysis for Cerebral Infarction. Internal Medicine 49:9, 833-836
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