MRI assessment followed by successful mechanical recanalization of a complete tandem (internal carotid/middle cerebral artery) occlusion and reversal of a 10-hour fixed deficit

Catalina C. Ionita, Junichi Yamamoto, Ramachandra P. Tummala, Elad I. Levy

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

BACKGROUND: Mechanical clot extraction up to 8 hours after stroke onset is an alternative strategy for opening large vessels, especially for patients ineligible for intravenous thrombolysis. Safety beyond this therapeutic window is untested. METHODS: An 81-year-old woman presented 8 hours after she developed left-sided weakness and dysarthria with a National Institutes of Health Stroke Scale (NIHSS) score fluctuating between 6 and 13. Neuroimaging revealed a large perfusion deficit with no diffusion abnormalities. An emergent cerebral angiogram revealed a complete internal carotid artery terminus occlusion. RESULTS: Successful mechanical thrombectomy was performed without complication and resulted in almost complete reversal of the patient's deficit to an NIHSS score of 1, 10 hours after stroke onset. CONCLUSION: Patients with large hypoperfused areas and minimal diffusion abnormalities on the MRI may benefit from mechanical thrombectomy beyond an 8-hour window.

Original languageEnglish (US)
Pages (from-to)93-95
Number of pages3
JournalJournal of Neuroimaging
Volume18
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Hypoperfusion
  • Ischemic stroke
  • MRI
  • Mechanical thrombectomy
  • Merci retriever

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