mechanical thrombectomy

From hypokinesia to hyperkinesia: An 86-year-old-woman with abnormal movements. De hipocinesia a hipercinesia: Mujer de 86 años con movimientos anormales

An 86-year-old woman presented with an acute onset of confusion, garbled speech, and decreased left arm movement. On exam, she had a forced right gaze, left homonymous hemianopsia, left hemiparesis, and left face and arm hypoesthesia. Forty-eight hours after successful revascularization therapies, the patient started complaining of abnormal involuntary movements. This manuscript discusses the phenomenology of these involuntary movements, their neuroanatomical correlates, management, and evolution. Neurologists should be mindful of post-stroke movement disorders, their latency period after stroke, and the functional-anatomic networks involved.

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Palabras clave: corea, Ictus, reporte de caso, trombectomía mecánica,

Keywords: case report, chorea, mechanical thrombectomy, stroke,

Trombectomía mecánica eficaz en paciente con ictus e infección por SARS-Cov-2 con desenlace fatal. Effective mechanical thrombectomy in a patient with stroke and SARS-Cov-2 infection with fatal outcome

Ischemic stroke has been reported in patients with SARS-CoV-2 infection. It is not clear if COVID-19 is causal or simply coexists or triggers the onset of stroke. Stroke is relatively rare in the context of COVID-19 and mostly occurs in the elderly with vascular risk factors. The underlying mechanism of stroke is multiple. We present an 84-year-old male with a stroke due to large vessel occlusion coincident with severe COVID-19 infection, that despite an initial successful mechanical thrombectomy, had a fatal outcome due to respiratory complications and contralateral massive cerebral infarction due to early recurrence. Consequently, vigilance in this type of patients should be extreme since ischemic stroke with active SARS-CoV-2 infection may have a poor prognosis.

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Palabras clave: Ictus isquémico, Infección por SARS-CoV-2, trombectomía mecánica,

Keywords: ischemic stroke, mechanical thrombectomy, SARS-CoV-2 infection,

Trombectomía Mecánica: Técnica de Primera Elección en el Tratamiento del Ictus Isquémico Agudo. Análisis de Beneficios y Resultados

The main objective of this article is to portrait mechanical thrombectomy as the modality of choice for interventional stroke treatment.

Methods and materials: Nine patients with acute ischemic stroke were diagnosed. Mechanical thrombectomy was perfomed in all of them with a solitaire type device associated with intraarterial rTPA. Eight patients (89%) had anterior vascular occlusion and only one (11%) had posterior vascular compromise. Treatment efficacy was assesed using a modified Rankin scale (mRs).

Results: Five patients (55%) had complete recovery while three of them (33%) had partial recovery. Only one patient (11%) showed no recovery at all.

Discussion: Although more data is needed, mechanical thrombectomy prooved to be effective and shows promising outcomes in patients with acute ischemic stroke.