Haruyama Hironori, Uno Junji, Takahara Kenta, Kawano Yosuke, Maehara Naoki, Michiwaki Yuhei, Nagaoka Shintaro, Maeda Kazushi, Ikai Yoshiaki, Gi Hidefuku
Department of Neurosurgery, Baba Memorial Hospital, Sakai City, Japan.
Case Rep Neurol. 2019 Sep 19;11(3):265-270. doi: 10.1159/000502349. eCollection 2019 Sep-Dec.
Primary anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. We herein report on the efficacy of mechanical thrombectomy (MT) in treating the distal ACA occlusion in a clinical setting.
A 76-year-old woman presented with a sudden onset of right hemiparesis. Computed tomographic angiography and perfusion imaging and subsequent analysis with RAPID software revealed acute left ACA occlusion with salvageable penumbra. The patient obtained a score of 11 on the National Institutes of Health Stroke Scale. MT was performed for occlusion of the left ACA (A4), and successful reperfusion (Thrombolysis in Cerebral Infarction score of 3) was achieved on the first attempt using a stent retriever. The patient's recovery progressed well, and she was discharged 13 days after admission with a modified Rankin Scale score of 1.
This case report demonstrates the clinical efficacy, safety, and favorable clinical outcome of treating a primary distal ACA occlusion with MT.
大脑前动脉(ACA)主干闭塞是一种罕见疾病,有时会导致严重的神经功能缺损。我们在此报告机械取栓术(MT)在临床环境中治疗远端ACA闭塞的疗效。
一名76岁女性突发右侧偏瘫。计算机断层血管造影和灌注成像以及随后使用RAPID软件进行的分析显示急性左侧ACA闭塞伴可挽救的半暗带。该患者美国国立卫生研究院卒中量表评分为11分。对左侧ACA(A4段)闭塞进行了MT治疗,首次尝试使用支架取栓器即实现了成功再灌注(脑梗死溶栓评分3分)。患者恢复良好,入院13天后出院,改良Rankin量表评分为1分。
本病例报告证明了MT治疗原发性远端ACA闭塞的临床疗效、安全性和良好的临床结局。