Delayed endovascular thrombectomy in a patient suffering from stroke in progression after intravenous thrombolytic therapy

研究成果: Article同行評審

1 引文 斯高帕斯(Scopus)

摘要

Purpose: Significant improvement of stroke symptoms may occur in acute stroke patients due to large artery occlusion (LAO) treated with intravenous thrombolysis (IVT). Directly proceeding with endovascular thrombectomy (EVT) would be a clinical dilemma. Case Report: A 55-year-old male suddenly suffered from global aphasia and right side hemiplegia at work. Left proximal middle cerebral artery (MCA) occlusion was shown on CT angiography. After IVT, NIHSS significantly improved from 11 to 4 points. EVT was withheld due to rapidly improving symptoms and low NIHSS scores. However, stroke in progression occurred 7 hours after onset with NIHSS scores increasing from 4 to 13 points. A follow-up brain CT scan showed an Alberta Stroke Program Early CT score of 9 and no hemorrhage. Successful recanalization of the left MCA by EVT was performed at 10.5 hours after onset. The patient was discharged with a NIHSS score of 3 and his modified Rankin Scale score was 0 at 3 months. Conclusion: In LAO patients, directly proceeding EVT following IVT may not be hesitated. In addition, while LAO patients with incomplete IV-tPA treatment responses result in transient improvement of neurological symptoms but later reversed, EVT may be a potential rescue therapy in carefully selected patients.

原文English
頁(從 - 到)18-21
頁數4
期刊Acta Neurologica Taiwanica
27
發行號1
出版狀態Published - 2018 一月 1

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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