Inoue Hiroyasu, Oomura Masahiro, Nishikawa Yusuke, Mase Mitsuhito, Matsukawa Noriyuki
Neurology, Nagoya City University Graduate School of Medical Sciences, Nagoya, JPN.
Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, JPN.
Cureus. 2022 Feb 9;14(2):e22071. doi: 10.7759/cureus.22071. eCollection 2022 Feb.
Clinical trials have proven the efficacy and beneficial therapeutic outcomes of endovascular therapy in patients with major arterial occlusion. However, its efficacy for very elderly patients, such as nonagenarians or centenarians, is not well established. In this case report, we describe the successful use of mechanical thrombectomy for the management of stroke in a centenarian. The 100-year-old woman with severe right-sided paralysis and total aphasia was admitted to our hospital approximately 30 min from the onset of symptoms. The National Institutes of Health Stroke Scale score was 24 at admission, and three-dimensional computed tomography angiography revealed occlusion in the M1 segment of left middle cerebral artery. She had persistent atrial fibrillation and was diagnosed with colon cancer one month prior to the admission. The modified Rankin Scale score before the stroke was 1, and she was generally independent. The patient successfully underwent mechanical thrombectomy, and recanalization with thrombolysis in cerebral infarction grade 3 was accomplished 129 minutes after the onset. The patient made a remarkable recovery with a National Institutes of Health Stroke Scale score of 4 at 48 h and was discharged home with a modified Rankin Scale score of 2 on day 8. Thus, mechanical thrombectomy can be performed with a good outcome even in centenarians.
临床试验已证实血管内治疗对主要动脉闭塞患者的疗效及有益的治疗结果。然而，其对非常年长的患者，如九十多岁或百岁老人的疗效尚未明确。在本病例报告中，我们描述了在一位百岁老人中成功使用机械取栓术治疗卒中的情况。这位100岁女性在症状发作后约30分钟被送入我院，入院时严重右侧偏瘫且完全失语。美国国立卫生研究院卒中量表（NIHSS）评分入院时为24分，三维计算机断层扫描血管造影显示左侧大脑中动脉M1段闭塞。她患有持续性心房颤动，入院前一个月被诊断为结肠癌。卒中前改良Rankin量表评分为1分，她通常生活自理。患者成功接受了机械取栓术，发病后129分钟实现了脑梗死溶栓分级3级的再通。患者恢复显著，48小时时NIHSS评分为4分，第8天出院时改良Rankin量表评分为2分。因此，即使是百岁老人，进行机械取栓术也可获得良好效果。
