Yamamoto Taiki, Ohshima Tomotaka, Sato Masaki, Goto Shunsaku, Ishikawa Kojiro, Nishizawa Toshihisa, Shimato Shinji, Kato Kyozo
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan.
NMC Case Rep J. 2017 Mar 8;4(2):55-58. doi: 10.2176/nmccrj.cr.2016-0214. eCollection 2017 Apr.
Posterior cerebral artery (PCA) strokes produce various symptoms. Therefore, the diagnosis is often delayed and patients arrive late for thrombolytic therapy. We report a case of acute isolated PCA occlusion that was successfully treated with endovascular clot aspiration. A 63-year-old man presented with right complete homonymous hemianopia. Diffusion-weighted image (DWI) showed a high-intensity area (HIA) in the occipital lobe, and magnetic resonance angiography (MRA) showed PCA occlusion. Emergency endovascular clot aspiration was performed immediately after the diagnosis. Blood flow in PCA completely recovered 210 min after symptom onset. DWI after surgery showed partial disappearance of HIA, and the patient recovered from the symptom of right complete homonymous hemianopia. Endovascular recanalization is useful for acute PCA occlusion. This is the first reported case of acute isolated PCA occlusion successfully treated with endovascular clot aspiration. Prompt reperfusion results in a good clinical course in patients with PCA stroke. In this case, endovascular clot aspiration resulted in prompt recanalization in a patient with acute isolated PCA occlusion.
大脑后动脉（PCA）卒中会产生多种症状。因此，诊断往往会延迟，患者接受溶栓治疗的时间也较晚。我们报告一例急性孤立性PCA闭塞病例，该病例通过血管内血栓抽吸术成功治疗。一名63岁男性出现右侧完全性同向偏盲。弥散加权成像（DWI）显示枕叶有一个高强度区域（HIA），磁共振血管造影（MRA）显示PCA闭塞。诊断后立即进行了紧急血管内血栓抽吸术。症状发作210分钟后，PCA血流完全恢复。术后DWI显示HIA部分消失，患者右侧完全性同向偏盲症状恢复。血管内再通术对急性PCA闭塞有效。这是首例报道的通过血管内血栓抽吸术成功治疗的急性孤立性PCA闭塞病例。及时再灌注可使PCA卒中患者获得良好的临床病程。在此病例中，血管内血栓抽吸术使一名急性孤立性PCA闭塞患者迅速实现了再通。
