Xu Ning, Meng Hao, Liu Tianyi, Feng Yingli, Qi Yuan, Wang Honglei
Department of Neurosurgery, The First Hospital of Jilin University, Changchun 130021, China,
Neuropsychiatr Dis Treat. 2018 Dec 21;15:69-74. doi: 10.2147/NDT.S184372. eCollection 2019.
A 45-year-old Chinese man presented with acute severe headache for 2 days. He was diagnosed as subarachnoid hemorrhage. Head CT and subsequent head digital subtraction angiography (DSA) showed left internal carotid artery (ICA) aneurysm in the supraclinoid segment. Stent-assisted coil embolization of aneurysm was performed. Three hours after the surgery, the patient was found to be drowsy and with paralysis of the right limb and slurred speech. Urgent head CT examination ruled out acute hemorrhage; however, DSA showed acute thrombosis in the left ICA between the branches of the ophthalmic artery and middle cerebral artery, which was probably from an acute in-stent thrombosis. Urokinase (100,000 units) was given through a micro-tube but failed to dissolve the thrombus; thus, stent embolectomy was performed, which successfully removed the thrombus. Repeat angiography showed that the left ICA was completely recanalized. Postoperatively, the patient regained consciousness and was well-limbed and fluent in speech. No neurological symptoms or signs were found at 6-, 12-, and 24-month follow-up.
一名45岁的中国男性因急性剧烈头痛2天前来就诊。他被诊断为蛛网膜下腔出血。头部CT及随后的头部数字减影血管造影（DSA）显示鞍上段左侧颈内动脉（ICA）动脉瘤。对动脉瘤进行了支架辅助弹簧圈栓塞术。术后3小时，发现患者嗜睡，右侧肢体瘫痪，言语不清。紧急头部CT检查排除了急性出血；然而，DSA显示在眼动脉和大脑中动脉分支之间的左侧ICA出现急性血栓形成，这可能源于急性支架内血栓形成。通过微导管给予尿激酶（100,000单位），但未能溶解血栓；因此，进行了支架取栓术，成功取出了血栓。重复血管造影显示左侧ICA完全再通。术后，患者恢复意识，肢体活动良好，言语流利。在6个月、12个月和24个月的随访中未发现神经症状或体征。
