Endovascular Mechanical Thrombectomy for Right Hemispheric Stroke Syndrome Due to Acute Left A1-A2 Junction Thromboembolic Occlusion.
- Resource Type
- Article
- Authors
- Scullen, Tyler; Milburn, James; Mathkour, Mansour; Amenta, Peter S.
- Source
- Ochsner Journal. Dec2023, Vol. 23 Issue 4, p347-352. 6p.
- Subject
- *STROKE
*ENDOVASCULAR surgery
*ISCHEMIC stroke
*INTERNAL carotid artery
*THROMBOEMBOLISM
*LACUNAR stroke
- Language
- ISSN
- 1524-5012
Background: Endovascular mechanical thrombectomy (EVT) for large vessel occlusions has had a dramatic impact on the management of acute ischemic stroke. Extended use of EVT beyond American Heart Association guidelines has been successful in carefully selected cases. Case Report: A 71-year-old male presented to our comprehensive stroke center upon awakening with mild left hemiparesis. He was found to have a chronic occlusion of the right supraclinoid segment of the internal carotid artery. Angiography demonstrated large vessel occlusion of the contralateral A1-A2 junction that was successfully recanalized. Imaging at 24 hours displayed no evidence of infarct, the patient rapidly improved during hospitalization, and he was discharged on postoperative day 7 with a National Institutes of Health Stroke Scale score of zero. Conclusion: We describe successful EVT of a patient presenting with false-localizing symptoms consistent with a right hemispheric acute ischemic stroke secondary to left A1-A2 junction large vessel occlusion. This case demonstrates the importance of a high index of suspicion when evaluating atypical stroke presentations and the effectiveness of EVT in the treatment of distal small caliber vessels. [ABSTRACT FROM AUTHOR]