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Prehospital Thrombolysis: A Manual from Berlin
05:52

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Published on: November 26, 2013

Thrombolytic therapy in acute cerebral infarction complicating diagnostic cardiac catheterization

Yu-Wei Chen1, Ming-Ming Sim, Eric E Smith

  • 1Department of Neurology, Li-Shin Hospital, Tao-Yuan, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|September 27, 2006
PubMed

Insights

This case study highlights a successful intervention for acute cerebral infarction during cardiac catheterization. Prompt thrombolytic therapy significantly improved patient outcomes, demonstrating its critical role in managing procedural strokes.

Area of Science:

  • Cardiology
  • Neurology
  • Interventional Radiology

Background:

  • Percutaneous coronary catheterization, while diagnostic and therapeutic, carries a risk of stroke.
  • Cerebral infarction following cardiac procedures can range from asymptomatic to severe, impacting patient prognosis.

Observation:

  • A 61-year-old woman developed acute cerebral infarction with global aphasia, right hemiplegia, and left gaze preference during diagnostic cardiac catheterization for unstable angina.
  • Immediate head CT revealed a hyperdense middle cerebral artery (MCA) sign, indicative of acute ischemic stroke.

Findings:

  • Intravenous thrombolytic therapy was administered within 2 hours of symptom onset.
  • The patient experienced a significant improvement, with the National Institutes of Health Stroke Scale score decreasing from 21 to 9 within 24 hours.
  • Follow-up imaging confirmed resolution of the hyperdense MCA lesion.

Implications:

  • This case underscores the critical importance of timely thrombolytic therapy for acute cerebral infarction occurring during cardiac catheterization.
  • Early recognition and intervention can lead to favorable neurological outcomes and reduce stroke-related morbidity.
  • Highlights the clinical benefit of thrombolysis in procedural strokes associated with cardiac interventions.

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