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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
COVID-19 Positive Stroke Patient With Large Vessel Occlusion in the Epidemic
Mustafa Cetiner1, Güngör Çakmakçı1, Muhammed Alperen Bardakçı1
1Department of Neurology, Kütahya Health Sciences University School of Medicine, Kütahya, TUR.
Insights
This case study highlights a successful endovascular thrombectomy for acute ischemic stroke with large vessel occlusion in a patient hospitalized with coronavirus disease (COVID-19). The intervention effectively restored blood flow and resolved neurological deficits during the epidemic.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Medicine
Background:
- Coronavirus disease (COVID-19) is associated with diverse neurological complications, including stroke.
- Acute ischemic stroke, particularly large vessel occlusion (LVO), poses significant management challenges during pandemics.
- Recent literature indicates a rise in stroke incidence among hospitalized COVID-19 patients.
Observation:
- A 71-year-old male hospitalized for COVID-19 developed sudden left-sided hemiparesis.
- Cerebral CT angiography revealed occlusion at the terminus of the right internal carotid artery.
- The patient also presented with splenic infarction, suggesting a systemic thrombotic event.
Findings:
- Endovascular therapy successfully recanalized the occluded internal carotid artery.
- The patient experienced complete resolution of left-sided hemiparesis post-procedure.
- The etiology of stroke was considered cryptogenic, potentially linked to COVID-19.
Implications:
- Endovascular thrombectomy is a viable and effective treatment for COVID-19-associated LVO stroke, even during epidemics.
- This case underscores the importance of considering thrombotic events in COVID-19 patients presenting with neurological symptoms.
- Successful management highlights the adaptability of stroke care protocols in infectious disease outbreaks.
Abstract:
COVID-19 disease causes various neurological disorders. Of these, stroke is the most devastating and difficult to manage in epidemic conditions. An increase in the rate of acute ischemic stroke in hospitalized coronavirus patients and stroke with large vessel occlusion due to COVID-19 disease have been reported in recent publications. The management of these patients is difficult and becomes even more challenging in epidemic conditions. A 71-year-old man suddenly developed left-sided weakness while he was hospitalized for COVID-19 disease. Cerebral computed tomographic angiography showed a terminus of the right internal carotid artery. The occluded vessel was completely recanalized by endovascular therapy. Left-sided hemiparesis resolved completely. As a result of this study, cryptogenic stroke was considered in the etiology of stroke. In this report, we present a case of stroke with COVID-19, who developed large vessel occlusion accompanied by splenic infarction while hospitalized due to COVID-19 disease and was successfully treated with endovascular thrombectomy under epidemic conditions.
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