Bricout Nicolas, Nouri Nasreddine, Henon Hilde, Estrade Laurent, Boustia Fakhreddine, Leclerc Xavier
1 Department of Interventional Neuroradiology, University of Lille, CHU Lille, Lille, France.
2 Department of Vascular Neurology, Stroke Unit, University of Lille, CHU Lille, Lille, France.
Interv Neuroradiol. 2019 Feb;25(1):47-50. doi: 10.1177/1591019918796490. Epub 2018 Aug 30.
This report describes the innovative management of a severe haemodynamic stroke related to an occlusive extracranial internal carotid artery dissection. Intravenous thrombolysis combined with endovascular treatment were undertaken on the basis of a total mismatch profile (National Institutes of Health stroke scale (NIHSS) score of 27 and infarct volume on diffusion-weighted imaging of 0 mL). Balloon angioplasty using a long and compliant balloon microcatheter allowed complete recovery of the intracranial blood flow. The patient showed dramatic clinical improvement (day 1, NIHSS 5) and favourable functional outcome (day 90, modified Rankin scale score 2). Day 90 follow-up brain magnetic resonance imaging revealed no ischaemic change and magnetic resonance angiography assessed the patency of the internal carotid artery.
本报告描述了一例与颅外颈内动脉夹层闭塞相关的严重血流动力学性卒中的创新管理。基于完全不匹配的情况（美国国立卫生研究院卒中量表（NIHSS）评分为27分，弥散加权成像梗死体积为0 mL），进行了静脉溶栓联合血管内治疗。使用长而顺应性好的球囊微导管进行球囊血管成形术，使颅内血流完全恢复。患者临床症状显著改善（第1天，NIHSS 5分），功能预后良好（第90天，改良Rankin量表评分为2分）。第90天的随访脑磁共振成像显示无缺血性改变，磁共振血管造影评估了颈内动脉的通畅情况。
