Endovascular treatment of an acute left middle cerebral artery >6 h post stroke in a patient presenting with dysphasia and dense right hemiplegia.
This paper describes the case of a 32-year-old man presenting with dense right hemiplegia and global aphasia caused by an acute left middle cerebral artery infarct that underwent successful endovascular therapy after being determined ineligible for intravenous tissue plasminogen activator. Clot transversion and balloon disruption followed by intra-arterial Alteplase resulted in successful re-canalization of his middle cerebral artery at 7 h 30 min. At 3 months post stroke, the patient had moderately severe expressive dysphasia but was mobilizing independently with normal right upper and lower limb strength. In conclusion, the 3 month outcome suggests that the therapeutic time window for endovascular therapy might exceed 6 h post stroke.
Chan
Kenny
K
Department of Neurology, Liverpool Hospital, Sydney, New South Wales, Australia.
Cordato
Dennis J
DJ
Kehdi
Elias E
EE
Schlaphoff
Glen
G
McDougall
Alan
A
D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods*; D003680:Deglutition Disorders / Q000209:etiology*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator