Abstract | BACKGROUND: Bilateral hemispheric dysfunction is devastating to consciousness. We present a unique case of a patient who developed bilateral middle cerebral artery infarcts with significant neurological improvement post bilateral thrombolysis in cerebral infarction (TICI) 3 thrombectomies. CASE DESCRIPTION: The patient is a 64-year-old woman who presented 3 hours after her husband was awakened and found her with left hemiplegia. She had a history of atrial fibrillation and had her apixaban held for 5 days before the coronary angiogram that she received the day before arrival. Upon presentation, she was antigravity on the right side and withdrawing on the left side. Computed tomography angiogram showed a right M1 occlusion and an left M2 occlusion. Computed tomography perfusion revealed a mismatch with large penumbra, and she was taken for mechanical thrombectomy. Mechanical thrombectomy was performed using a combination of stent retriever and aspiration catheter with a TICI 3 revascularization. By the following morning, the patient was full strength on the right and antigravity on the left with a left facial droop. The patient recovered her speech and was fully oriented before leaving for rehabilitation on postoperative day 3. CONCLUSIONS:
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Authors | Christopher Storey, Jonathon Lebovitz, Ahmad Sweid, Stavropoula Tjoumakaris, Reid Gooch, Robert H Rosenwasser, Pascal Jabbour |
Journal | World neurosurgery
(World Neurosurg)
Vol. 132
Pg. 165-168
(Dec 2019)
ISSN: 1878-8769 [Electronic] United States |
PMID | 31505295
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2019 Elsevier Inc. All rights reserved. |
Topics |
- Angiography, Digital Subtraction
- Computed Tomography Angiography
- Female
- Hemiplegia
(etiology)
- Humans
- Infarction, Middle Cerebral Artery
(surgery)
- Middle Aged
- Stents
- Stroke
(etiology, surgery)
- Suction
- Thrombectomy
(methods)
- Tomography, X-Ray Computed
- Treatment Outcome
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