{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:08Z","timestamp":1784557028530,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Mass effect from a goiter is a serious complication with potentially life-threatening consequences. In rare instances, a goiter can compress nearby vessels, compromising cerebral blood flow, which can lead to an ischemic stroke. Ischemic strokes generally occur due to atherogenic or embolic phenomenon, albeit a rare etiology can be due to a mechanical obstruction of great vessels of the neck that provide blood supply to the brain. An unusual example of a similar obstruction is the mass effect of an expansive goiter on the carotid artery (CA) in the neck. We present a rare case of a 90-year-old female who had a historically untreated goiter for 13 years. She presented with symptoms of acute stroke, including right-sided weakness and dysarthria. CT angiogram of the neck revealed a massively enlarged thyroid gland causing compression and intermittent obstruction of the blood flow in the left common CA. Subsequently, the patient underwent a total thyroidectomy. Postoperatively, she had a remarkable recovery of her symptoms of right-sided weakness and dysarthria. Acknowledging stroke as a grave mechanical complication of a large multinodular goiter is crucial for timely and appropriate management to avoid serious consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>The natural history of euthyroid multinodular goiters include abnormal enlargement of the thyroid gland, which results in local compression of structures in the neck causing neurovascular injury.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Timely diagnosis and surgical management of an enlarging goiter compressing the CA can reduce morbidity from an ischemic stroke.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Ischemic stroke is a rare and dangerous complication of a giant multinodular goiter.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-22-0247","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T04:15:17Z","timestamp":1656044117000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Ischemic stroke: a rare complication of a large multinodular goiter"],"prefix":"10.1530","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7913-8018","authenticated-orcid":true,"given":"Yudi","family":"Camacho","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3590-6510","authenticated-orcid":true,"given":"Yusra","family":"Jamal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Westchester Medical Center, Valhalla, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Chiarolanzio","sequence":"additional","affiliation":[{"name":"Department of Radiology, Westchester Medical Center, Valhalla, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayotri","family":"Goswami","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"European Thyroid Journal","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1159\/000480348","article-title":"Thyroidectomy improves tracheal anatomy and airflow in patients with nodular goiter: a prospective cohort study","volume":"6","author":"Sorensen","year":"2017","unstructured":"Sorensen JRLauridsen JFD\u00f8ssing HNguyen NHeged\u00fcs LBonnema SJGodballe C. Thyroidectomy improves tracheal anatomy and airflow in patients with nodular goiter: a prospective cohort study. European Thyroid Journal20176307\u2013314. (https:\/\/doi.org\/10.1159\/000480348)10.1159\/0004803483733354"},{"key":"bib2","series-title":"European Thyroid Journal","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1159\/000493542","article-title":"The impact of esophageal compression on goiter symptoms before and after thyroid surgery","volume":"8","author":"Brinch","year":"2019","unstructured":"Brinch FAD\u00f8ssing HNguyen NBonnema SJHeged\u00fcs LGodballe CSorensen JR. The impact of esophageal compression on goiter symptoms before and after thyroid surgery. European Thyroid Journal2019816\u201323. 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Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ2015187887\u2013893. 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