A case of brain infarction in a pregnant woman during 37^th gestational week, recovered fully by drip, ship, and retrieve and successfully delivered her baby

Abstract

We report a case of cerebral infarction due to middle cerebral artery (MCA) occlusion in a pregnant woman successfully treated by endovascular thrombectomy. A 33-year-old woman (gravida 1, para 1) at 37^th gestational week presented a sudden onset of right hemiparesis. She was transferred to a nearby hospital and her National Institutes of Health Stroke Scale (NIHSS) was 13 with no significant ischemic change in head computed tomography (CT) scan. Magnetic resonance imaging (MRI) demonstrated occlusion of the first segment of right MCA, and Alberta Stroke Program Early CT Score-Diffusion Weight Imaging (DWI-ASPECTS) score was eight. Drip of recombinant tissue plasminogen activator (rt-PA) was initiated and she was transferred to our hospital for endovascular thrombectomy. On arrival, she showed no neurological improvement. Subsequent thrombectomy achieved thrombolysis in cerebral infarction (TICI) score 2b. She gave birth to a baby boy 2 days after the treatment by a caesarean section, and showed significant improvement of hemiparesis with NIHSS score 0 at discharge. This is the case of drip, ship, retrieve, and childbirth that was successfully performed.