Cardiology Department, Mohammed V Military Instruction Hospital, Mohammed V University, Rabat, Morocco.
Radiology Department, Mohammed V Military Instruction Hospital, Mohammed V University, Rabat, Morocco.
Pan Afr Med J. 2021 Nov 19;40:172. doi: 10.11604/pamj.2021.40.172.32031. eCollection 2021.
Cerebrovascular events are rare but devastating events that can complicate any coronary intervention. In the vast majority of cases, they involve major cerebral arteries. We report the case of a 56-year-old woman admitted for unstable angina associated with severe left systolic dysfunction. She developed moderate cerebellar stroke while undergoing percutaneous coronary intervention, with a national institutes of health stroke scale score of 5. Immediate systemic thrombolysis was performed, but her neurological status deteriorated. A large hemorrhagic transformation was then diagnosed, and she died despite surgical intervention. Periprocedural strokes are marred with high morbidity and mortality, therefore preventionis key, as many risk factors can be controlled or mitigated. Our patient presented many of these factors; they can be procedure-related (transfemoral approach, anticoagulation) or patient-related (age, diabetes mellitus, uncontrolled hypertension, diffuse atherosclerosis).
脑血管事件是罕见但具有破坏性的事件，可使任何冠状动脉介入复杂化。在绝大多数情况下，它们涉及大脑主要动脉。我们报告了一例 56 岁女性患者，因不稳定型心绞痛伴严重左心室收缩功能障碍入院。她在接受经皮冠状动脉介入治疗时发生中度小脑中风，美国国立卫生研究院中风量表评分为 5 分。立即进行全身溶栓，但她的神经状态恶化。然后诊断出大面积出血性转化，尽管进行了手术干预，她还是死亡了。围手术期中风的发病率和死亡率都很高，因此预防是关键，因为许多危险因素可以得到控制或减轻。我们的患者存在许多这些因素；它们可能与手术相关（经股动脉入路、抗凝）或与患者相关（年龄、糖尿病、未控制的高血压、弥漫性动脉粥样硬化）。
