title: Acute Middle Cerebral Artery Occlusion Treated by Thrombectomy in a Patient with Myelodysplastic Syndrome and Severe Thrombocytopenia.
abstract: OBJECTIVE
  Experience on thrombolysis and/or thrombectomy for acute major ischemic strokes in the setting of deep (less than 40,000/mm(3)) thrombocytopenia is limited.
  
  
  METHODS
  Case report and review of the literature.
  
  
  RESULTS
  A 63-year-old female with myelodysplastic syndrome presented with left middle cerebral artery stroke within 2 hours of symptom onset. Severe thrombocytopenia (10.000/mm(3)) precluded systemic thrombolysis. However, endovascular thrombectomy provided successful recanalization and dramatic clinical recovery with NIHSS score decreasing from 20 to 2 soon after the procedure. Her modified Rankin scale was 1 at the end of the third month.
  
  
  CONCLUSIONS
  This exceptional case highlights that neurothrombectomy could be feasible and of justifiable merit even in the setting of critically low thrombocytopenia if a meticulous procedure is followed in subjects with severe acute stroke.
authors.affiliation: Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Onder
authors.affiliation: Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Murat Arsava
authors.affiliation: Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey.
authors.forename: Anıl
authors.initials: A
authors.lastname: Arat
authors.affiliation: Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey.
authors.forename: M Akif
authors.initials: MA
authors.lastname: Topcuoglu
keywords: acute stoke; platelet counts; thrombectomy; thrombocytopenia; tissue plasminogen activator