[Thrombectomy of the middle cerebral artery (author's transl)]

The case reports on the thrombo-embolectomy in the middle cerebral artery have been presented in a little frequency since 1954 when it was reported by Welch. But those in the acute stage have been reported very little. The present case concerns a male of 55 years old, who begun with the partial paralysis of the left upper limb and at the time of his entering the hospital, 24 hours later from onset, he showed the complete paralysis of the left upper limb and partial paralysis of the lower limb. His consciousness was in a mild confusional state. By the cerebral angiography, we could recognize the findings of obstruction in the right middle cerebral artery (the origin of angular artery), and see the retrograde filling from the right anterior cerebral artery. CT showed normal findings. Thrombectomy of the right middle cerebral artery was performed 30 hours later from the appearance of upper limb palsy (about 6 hours later from the onset of left hemiparesis). A fresh thrombus was easily extracted from the angular and central sulcus arteries. There occurred no serious complications after operation and then the improvement of the paralysis was recognized. This case was reported to be of help to judge the indication of such operation in an acute period and its effectiveness.