Amoda Oluyemisi, A Elmarie, Uwagbale Ese
Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA.
Cureus. 2021 Jun 25;13(6):e15915. doi: 10.7759/cureus.15915. eCollection 2021 Jun.
Cerebrovascular accidents (CVA) or strokes cause focal neurological deficits, which may be due to rupture or occlusion of blood vessels supplying areas of the brain. Atrial fibrillation (AF) is an independent and significant risk factor for ischemic CVA, mainly via the embolic pathway. This is evident as newly diagnosed patients with AF are typically started on anticoagulation therapy if their CHA2DS2-VASc score is equal to or greater than two. Furthermore, ischemic CVA may occur as a thrombotic phenomenon due to significant vessel atherosclerotic disease involving plaque ulceration and rupture. Such a phenomenon may be curtailed with antiplatelet therapy in at-risk patient populations, particularly as a form of secondary prevention. This case highlights the unfortunate incidence of an ischemic CVA in a patient using dual antiplatelet therapy (DAPT) and anticoagulation.
脑血管意外（CVA）或中风会导致局灶性神经功能缺损，这可能是由于供应脑区的血管破裂或阻塞所致。心房颤动（AF）是缺血性CVA的一个独立且重要的危险因素，主要通过栓塞途径。这一点很明显，因为新诊断的AF患者如果其CHA2DS2-VASc评分等于或大于2，通常会开始接受抗凝治疗。此外，缺血性CVA可能是由于涉及斑块溃疡和破裂的严重血管动脉粥样硬化疾病而出现的血栓形成现象。在高危患者群体中，这种现象可以通过抗血小板治疗得到缓解，特别是作为二级预防的一种形式。本病例突出了一名正在使用双联抗血小板治疗（DAPT）和抗凝治疗的患者发生缺血性CVA的不幸事件。
