Abstract
We report a'case of cerebral embolism of left middle cerebrall artery cured by the intravascular surgery using 480, 000 units of urokinase.
A 32-year-old woman who was admitted in order to undergo the open heart surgery of combined valvular disease developed sudden loss of consciousness, right hemiparesis and aphasia. CT scan showed no abnormal density areas. Left carotid angiogram revealed a embolus lodged at the horizontal portion of the left middle cerebral artery. Then intravascular surgery was started at 110 minutes after the onset. After 240, 000 units of urokinase was injected twice through the catheter inserted into the left internal carotid artery, embolus disappeared and left middle cerebral artery was recanalized. At four hours and thirty minutes after the onset, almost all of her neurological deficits had disappeared. On the fourth day after the onset, she underwent the thrombectomy and open mitral commissurotomy with cardiopulmonary bypass using minimal dose of heparin (6000 units).
During and after the operation, no new neurological symptoms occurerred.
She was discharged on the fifteenth day after the operation and returned to her normal daily life.
