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Successful double mechanical thrombectomy in bilateral M1 middle cerebral artery occlusion

  • Delphine London
  • Frédéric LondonEmail author
  • Yves Vandermeeren
  • Fabrice C. Deprez
Letter to the Editor
  • 16 Downloads

Introduction

Multivessel occlusion (MVO) is not uncommon in patients with acute ischemic stroke (AIS) and arises most commonly from thromboembolic sources such as atrial fibrillation (AF). Acute bilateral middle cerebral artery (MCA) M1 segment occlusion is, however, rare, but raises significant issues for stroke neurologists and interventional radiologists regarding which lesion should be treated first. We describe a case of acute bilateral MCA M1 segment occlusion successfully treated with bilateral thrombectomy.

Case presentation

An 84-year-old woman with history of atrial fibrillation and arterial hypertension was admitted to the Emergency Department at 11.10 p.m. At 8.50 p.m., she presented an aphasia and a right faciobrachial palsy. The initial National Institutes of Health Stroke Scale (NIHSS) score was 11. She was intubated and sedated before admission due to seizures. Brain computed tomography (CT) demonstrated bilateral hyperdense MCA and CT angiography confirmed bilateral...

Keywords

Stroke Bilateral M1 occlusion Mecanical thrombectomy 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest regarding this case report.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

References

  1. 1.
    Bhatia R, Hill MD, Shobha N, Menon B, Bal S, Kochar P et al (2010) Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke: real-world experience and a call for action. Stroke 41:2254–2258CrossRefGoogle Scholar
  2. 2.
    Campbell BCV, Donnan GA, Lees KR, Hacke W, Khatri P, Hill MD et al (2015) Endovascular stent thrombectomy: the new standard of care for large vessel ischaemic stroke. Lancet Neurol 14:846–854CrossRefGoogle Scholar
  3. 3.
    Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, HERMES collaborators et al (2016) Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 387:1723–1731CrossRefGoogle Scholar
  4. 4.
    Kaesmacher J, Mosimann PJ, Giarusso M, El-Koussy M, Zibold F, Piechowiak E et al (2018) Multivessel occlusion in patients subjected to thrombectomy: prevalence, associated factors and clinical implications. Stroke 49:1355–1362CrossRefGoogle Scholar
  5. 5.
    Dietrich U, Graf T, Schäbitz WR (2014) Sudden coma from acute bilateral m1 occlusion: successful treatment with mechanical thrombectomy. Case Rep Neurol 6:144–148CrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  • Delphine London
    • 1
  • Frédéric London
    • 2
    Email author
  • Yves Vandermeeren
    • 2
  • Fabrice C. Deprez
    • 1
  1. 1.Department of Radiology, CHU UCL NamurUniversité catholique de Louvain (UCLouvain)YvoirBelgium
  2. 2.Department of NeurologyCHU UCL Namur, Université catholique de Louvain (UCLouvain)YvoirBelgium

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