Cardiac Hemangioma of the Right Atrium: A Possible Cause of Cerebellar Stroke

154 rological deterioration was only prevented by pharmacologically induced elevation of blood pressure, supporting the need of an urgent revascularization to prevent additional permanent damage. At least partially, cerebral perfusion to the left hemisphere could also have been improved by stenting the high-grade stenosis at the origin of the left VA. While we did not find any reports on emergency bypass surgery of an occluded CCA, we encountered several case reports and small studies dealing with both successful emergency thrombendarterectomy or angioplasty and stenting of an occluded ICA [5, 6] . In contrast to an endovascular approach, in our case the surgical approach offered the opportunity to ligate the CCA to prevent further embolic events, which often arise from the stump of an occlusion [7] . Despite the lack of a generalized efficacy of bypass surgery for occlusive carotid disease [8] , emergency surgical recanalization of an acute atherothrombotic CCA occlusion is technically feasible and holds promise to avoid major stroke in selected cases with insufficient cerebrovascular collateralization or repeated post-occlusive thromboembolic events.