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J Clin Neurosci. 2013 Oct;20(10):1455-7. doi: 10.1016/j.jocn.2012.10.038. Epub 2013 Jul 8.

Clopidogrel effective for frequent transient monocular blindness caused by vulnerable plaque.

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  • 1Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.


Transient monocular blindness (TMB) is a well-known warning symptom of impending cerebral or retinal infarction, which suggests vulnerable ipsilateral carotid disease. Instability of free-floating thrombus may cause recurrent artery-to-artery embolism. A recent study showed that a combination of clopidogrel and aspirin might reduce microthromboembolisms. Here, we report a patient with frequent TMB despite aspirin monotherapy whose symptom disappeared after the addition of clopidogrel. This is the first report of aspirin-resistant frequent TMB caused by thromboembolism from vulnerable plaque that remitted after the addition of clopidogrel. These findings highlight the need for a randomized controlled trial to illustrate the most efficacious treatment strategy in this situation.

Copyright © 2013 Elsevier Ltd. All rights reserved.


Clopidogrel loading; Free-floating thrombus; Transient monocular blindness; Vulnerable plaque

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