A Case of Intravascular Treatment for Acute Ischemic Stroke with Internal Carotid Artery Stenosis That Developed While Driving

Yuta Oyama; Michiyuki Miyamoto; Takahiro Onuki; Takeshi Uno; Akihiro Ito; Fumitaka Yamane; Tetsuya Sakamoto; Akira Matsuno

doi:10.5797/jnet.cr.2019-0090

Case Reports

A Case of Intravascular Treatment for Acute Ischemic Stroke with Internal Carotid Artery Stenosis That Developed While Driving

Yuta Oyama, Michiyuki Miyamoto, Takahiro Onuki, Takeshi Uno, Akihiro Ito, Fumitaka Yamane, Tetsuya Sakamoto, Akira Matsuno

著者情報

Yuta Oyama
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Department of Emergency Medicine, Trauma and Resuscitation Center, Teikyo University School of Medicine, Tokyo, Japan
Michiyuki Miyamoto
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Takahiro Onuki
Department of Emergency Medicine, Trauma and Resuscitation Center, Teikyo University School of Medicine, Tokyo, Japan
Takeshi Uno
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Akihiro Ito
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Fumitaka Yamane
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Tetsuya Sakamoto
Department of Emergency Medicine, Trauma and Resuscitation Center, Teikyo University School of Medicine, Tokyo, Japan
Akira Matsuno
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan

キーワード: traffic accident, internal carotid stenosis, acute ischemic stroke, intervention

ジャーナルオープンアクセス

2020 年 14 巻 8 号 p. 313-318

DOI https://doi.org/10.5797/jnet.cr.2019-0090

Browse “Advance online publication” version

詳細

抄録

Objective: We report a case of acute cerebral infarction that may have been associated with high-energy trauma due to onset while driving.

Case Presentation: A 67-year-old man had a traffic accident. His neurological symptoms were left hemiplegia and contrast CT revealed right middle cerebral artery occlusion. Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) and intravascular treatment were performed. Right carotid artery angiography demonstrated internal carotid artery stenosis. Middle cerebral artery (MCA) revascularization was performed only by percutaneous transluminal angioplasty (PTA) of the internal carotid artery. Thoracic hemorrhage was observed a few hours after surgery, and hemostasis was performed by thoracotomy. Carotid artery stenting (CAS) was performed 8 days after onset. The patient was transferred to a convalescent rehabilitation hospital.

Conclusion: Rt-PA and acute CAS were not recommended for cerebral infarction due to traffic accident.

責任著者(Corresponding author)

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