A Case of Bilateral Middle Cerebral Artery Stenosis with Unilateral M1 Stenting
1Dr Farzana Alam, Assistant Professor, Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;
Insights
Recurrent stroke is a major health issue in Bangladesh. Percutaneous transluminal angioplasty with stenting effectively prevented recurrent stroke in a patient with severe intracranial atherosclerotic disease.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Stroke is a leading cause of death and disability in Bangladesh.
- Intracranial atherosclerotic disease (ICAD) is a significant cause of recurrent stroke.
- Effective management strategies for ICAD are crucial.
Observation:
- A 60-year-old male presented with a history of recurrent stroke.
- The patient had severe bilateral middle cerebral artery atherosclerotic stenosis (100% right, 52% left).
- Symptoms were present in the dominant (left) hemisphere.
Findings:
- Percutaneous transluminal angioplasty with stenting was performed to address the stenosis.
- The procedure aimed to prevent further ischemic events and improve brain perfusion.
- The patient remained stroke-free for 22 months post-intervention.
Implications:
- Percutaneous transluminal angioplasty with stenting is a viable treatment for symptomatic ICAD.
- This intervention can effectively reduce the risk of recurrent stroke.
- The findings support stenting as a preventive measure for ICAD patients.
Abstract:
Stroke is not only the third leading cause of death in Bangladesh but it also causes a high number of disability adjusted life years loss (485 per 10,000 people). Appropriate treatment of recurrent stroke has to be established. Here we present A 60 year's old male patient with history of recurrent stroke who came in our out patient department. He had progressing bilateral middle cerebral artery atherosclerotic stenosis (100.0% on right side and 52.0% on left side) which was less severs but symptomatic at dominant hemisphere (left). Percutaneous transluminal angioplasty with stenting was done to prevent further ischemia and to increase the blood supply of remaining brain parenchyma. On post stenting follow-up patient did not suffered from any new event of stroke for about 22 months. Percutaneous transluminal angioplasty with stenting is an effective procedure to prevent recurrent stroke for intracranial atherosclerotic disease.
