临床荟萃

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觉醒型缺血性卒中进展后动脉内治疗1例并文献复习

  

  1. 解放军第306医院 神经内科,北京 100101
  • 出版日期:2018-12-05 发布日期:2019-01-17
  • 通讯作者: 通信作者:蔡艺灵,Email:cailing@vip.sina.com
  • 基金资助:
    首都临床特色应用研究与成果推广项目(Z171100001017142)

Endovascular therapy in progressive wakeup stroke:  a case report and literature review

  1. Department of Neurology,  the 306th Hospital of PLA, Beijing 100101,  China
  • Online:2018-12-05 Published:2019-01-17
  • Contact: Corresponding author: Cai Yiling,Email:cailing@vip.sina.com

摘要: 目的 探讨多模式影像学选择的觉醒型缺血性卒中(WUS)患者进行静脉溶栓以及动脉内治疗的临床疗效。方法 解放军第306医院对1例WUS患者进行静脉溶栓桥接动脉取栓并急诊支架成形术治疗,随访90天,将临床资料进行总结与分析。结果 经过静脉溶栓后患者症状部分缓解,很快再次加重,随即进行动脉取栓并发现责任大脑中动脉重度狭窄,取栓后血流不能维持,给予急诊支架植入。病情演变过程复杂,最终结局良好,神经功能缺损改善。90天随访:患者痊愈,NIHSS  0分,mRS  0级。结论 对于WUS患者,通过多模式影像学选择后进行静脉溶栓以及动脉内治疗是安全有效的。

关键词: 脑梗死, 溶栓, 血管内治疗

Abstract: Objective  To investigate the clinical efficacy of intravenous thrombolysis and endovascular therapy in Wakeup stroke (WUS) patients selected by multimode imaging. Methods  One WUS patient was treated with intravenous thrombolytic bridging arterial thrombolysis and emergency stent implantation in the 306th Hospital of PLA and followed up for 90 days. The clinical data were summarized and analyzed. Results  After intravenous thrombolysis, the symptoms were partially relieved, but aggravated again. Then thrombectomy was performed and severe middle cerebral artery stenosis was found. After thrombectomy, the blood flow could not be maintained and emergency stent implantation was given. The course of the disease was complex, however, the final outcome was good. The patient recovered with NIHSS 0 score and mRS 0 level in 90 days followup. Conclusion  For WUS patients, intravenous thrombolysis and endovascular therapy are safe and effective after multimode imaging.

Key words: brain infarction, thrombolysis, endovascular therapy