Yoshida Shota, Miyakoshi Akinori, Arai Daisuke, Kawanabe Yoshifumi, Sato Tsukasa
Department of Neurosurgery, Shizuoka General Hospital, Shizuoka, Shizuoka, Japan.
J Neuroendovasc Ther. 2022;16(4):204-210. doi: 10.5797/jnet.cr.2020-0178. Epub 2021 Aug 26.
Large vessel occlusion (LVO) stroke during pregnancy is rare but a life-threatening issue for the mother and fetus. We report a rare case of a pregnant woman with congenital protein S deficiency who underwent mechanical thrombectomy.
A 35-year-old woman presented with right hemiplegia and aphasia. The National Institutes of Health Stroke Scale was 23 and MRI revealed acute infarction on the left hemisphere. MRA showed disruption of the left middle cerebral artery. Mechanical thrombectomy was performed following intravenous thrombolysis, and then complete recanalization was achieved. The reduction in protein S activity due to pregnancy was suspected to have affected LVO. Subsequently, the patient was diagnosed with congenital protein S deficiency and recovered to modified Rankin scale 2 at 3 months after the onset.
Aggravation of congenital protein S deficiency due to pregnancy led to the onset of LVO. The patient showed a good outcome after mechanical thrombectomy.
妊娠期大血管闭塞(LVO)性卒中罕见,但对母亲和胎儿均构成生命威胁。我们报告一例罕见的先天性蛋白S缺乏的孕妇接受机械取栓治疗的病例。
一名35岁女性出现右侧偏瘫和失语。美国国立卫生研究院卒中量表评分为23分,MRI显示左半球急性梗死。MRA显示左大脑中动脉中断。在静脉溶栓后进行了机械取栓,随后实现了完全再通。怀疑妊娠导致的蛋白S活性降低影响了LVO。随后,患者被诊断为先天性蛋白S缺乏,发病3个月后恢复至改良Rankin量表2级。
妊娠导致先天性蛋白S缺乏加重,进而引发LVO。患者在机械取栓后预后良好。