Scharf E L, Cloft H J, Wijdicks E
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Neurocrit Care. 2016 Apr;24(2):268-72. doi: 10.1007/s12028-015-0186-x.
To describe a rare presentation of ischemic stroke secondary to angioinvasive mucormycosis and endovascular retrieval of mycotic thrombus with stenting of the compressed vessel.
We report a case of angioinvasive mucormycosis that externally compressed and invaded the internal carotid artery causing ischemic cerebral infarction. A sample of the thrombus was obtained using a stent retriever. Subsequent pathological analysis was shown to be consistent with the diagnosis of angioinvasive mucormycosis. The thrombosed and compressed segment was recanalized with the deployment of a stent.
The endovascular placement of an expandable stent in the setting of angioinvasive mucormycosis restored good cerebral blood flow in a proximal internal carotid artery occlusion. The patient's aphasia resolved following this intervention. Artifacts of CT angiography may result in the overestimation of acute arterial occlusions. Endovascular carotid stenting may be a palliative measure in the setting of angioinvasive rhino-cerebro-orbital mucormycosis.
描述血管侵袭性毛霉菌病继发缺血性卒中的罕见表现,以及通过支架置入受压血管对霉菌性血栓进行血管内取出。
我们报告1例血管侵袭性毛霉菌病病例,该病从外部压迫并侵犯颈内动脉,导致缺血性脑梗死。使用支架取栓器获取血栓样本。随后的病理分析结果与血管侵袭性毛霉菌病的诊断一致。通过支架置入使血栓形成且受压的节段再通。
在血管侵袭性毛霉菌病情况下,可扩张支架的血管内放置恢复了颈内动脉近端闭塞时良好的脑血流。该干预措施后患者的失语症状得到缓解。CT血管造影的伪影可能导致对急性动脉闭塞的高估。血管内颈动脉支架置入术可能是血管侵袭性鼻脑眶毛霉菌病情况下的一种姑息性措施。