[重组组织型纤溶酶原激活剂治疗对侧大脑中动脉闭塞后立即颈内动脉闭塞1例]。

Q3 Medicine
Yasushi Takeda, Atsutomo Hashida, Koichiro Futatsuya, Yohei Takeshita, Hirotsugu Ohta, Junkoh Yamamoto
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引用次数: 0

摘要

早期复发性缺血性脑卒中(ERIS)以及症状性颅内出血(siich)和进行性脑卒中(PS)可导致早期神经功能恶化。我们在此报告一例右颈内动脉(ICA)闭塞的患者,在静脉注射重组组织型纤溶酶原激活剂(rt-PA)治疗左大脑中动脉(MCA)闭塞后立即出现。一名79岁妇女因嗜睡、失语和右半瘫被送往我院。MRI显示左内囊急性梗死,左大脑中动脉闭塞。在事件发生2小时后,患者静脉注射rt-PA。她的意识障碍和失语有所改善,但右半瘫没有好转。我们进行了紧急血管内取栓术,但在手术中右颈段被阻塞。最后,血管内取栓实现了左MCA和右ICA的再通。在进行静脉溶栓时,应注意再闭塞的可能性,做好介入治疗的准备。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A Case of the Internal Carotid Artery Occlusion Immediately After Intravenous Recombinant Tissue Plasminogen Activator Treatment for Contralateral Middle Cerebral Artery Occlusion].

Early recurrent ischemic stroke (ERIS), as well as symptomatic intracranial hemorrhage (SICH) and progressive stroke (PS), causes early neurological deterioration. Here we report a case of a patient with right internal carotid artery (ICA) occlusion immediately after intravenous recombinant tissue plasminogen activator (rt-PA) treatment for left middle cerebral artery (MCA) occlusion. A 79-year-old woman with drowsiness, aphasia and right hemiparesis was brought to our hospital. MRI showed acute infarction in the left internal capsule and occlusion of the left middle cerebral artery. rt-PA was administered intravenously to the patient 2 hours after the onset of the event. Her consciousness disturbance and aphasia improved, but the right hemiparesis did not. We performed emergent endovascular thrombectomy, but the right ICA (cervical portion) was occluded during the surgery. Finally, the endovascular thrombectomy achieved the recanalization of the left MCA and right ICA. When performing intravenous thrombolysis, we should beware the possibility of re-occlusion and prepare for interventional treatment.

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来源期刊
Journal of UOEH
Journal of UOEH Medicine-Medicine (all)
CiteScore
1.30
自引率
0.00%
发文量
35
期刊介绍: Published quarterly: 1 annual volume consisted of 4 numbers. Issued on the 1st of March, June, September and December, respectively.
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