Repeated Subarachnoid Hemorrhage after Mechanical Thrombectomy for Middle Cerebral Artery Occlusion: A Case Report.

Abstract

Objective: We report a rare case of subarachnoid hemorrhage after mechanical thrombectomy that worsened after a period of 72 h after the maneuver.

Case Presentation: An 80-year-old male had mechanical thrombectomy for right middle cerebral artery M1 occlusion. After maneuver, hemorrhage in the right Sylvian fissure was observed, but there was no expansion in the next day, so we started to use heparin. On the 5th day of hospitalization, he exhibited sudden disturbance of consciousness and left hemiparalysis, and head CT scan showed diffuse subarachnoid hemorrhage. Angiography did not show any obvious cause of hemorrhage. He was treated with conservative therapy and was transferred to a rehabilitation hospital.

Conclusion: The cause of hemorrhage was probably the rupture of a small blood vessel, and the hemorrhage was thought to have worsened with the use of heparin. It is necessary to discuss in the future about the possibility of hemorrhage that worsens after mechanical thrombectomy.