Thrombectomy for ischemic stroke with large vessel occlusion and concomitant subarachnoid hemorrhage.
J Thromb Thrombolysis
; 52(4): 1212-1214, 2021 Nov.
Article
en En
| MEDLINE
| ID: mdl-34105087
ABSTRACT
To report our experience in treating one patient with nontraumatic subarachnoid hemorrhage (SAH) and concurrent acute ischemic stroke (AIS) due to large vessels occlusion (LVO). A man in his 50 s presented with acute right hemiparesis and aphasia. Brain CT showed a SAH in the left central sulcus; CT-angiography revealed a tandem occlusion of the left internal carotid artery and homolateral middle cerebral artery. He underwent an angiographic procedure with successful recanalization. Follow-up CT demonstrated a striatal-lenticular stroke without SAH progression. While the absolute contraindication to IVT during intracranial bleeding remains unquestionable, the potential injury/benefit from MT is still debatable. Such cases constitute a blind spot in the guidelines where physicians face the dilemma of choosing between an acute endovascular treatment with the risks of hemorrhage progression and a conservative treatment with the associated poor clinical outcome. We decided to treat our patient invasively, considering the young age, also given the absence of prognostic factors that generally predict post-procedural reperfusion injury. We believe that, in similar cases, MT should be considered-despite not free of risks and drawbacks-to avoid the detrimental consequences of untreated AIS from LVO.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Hemorragia Subaracnoidea
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Isquemia Encefálica
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Accidente Cerebrovascular Isquémico
Tipo de estudio:
Etiology_studies
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Guideline
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Observational_studies
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Prognostic_studies
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Año:
2021
Tipo del documento:
Article