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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(08): 690-691
DOI: 10.1590/0004-282X20160099
IMAGES IN NEUROLOGY

Early reperfusion therapy in acute ischemic stroke after recent myocardial infarction

Otimizando os benefícios da terapia de reperfusão precoce no AVC agudo após infarto agudo do miocárdio
Gustavo Wruck Kuster
1   Hospital Total Cor, São Paulo SP, Brasil;
2   Hospital Paulistano, São Paulo SP, Brasil;
,
Antonio Claudio Baruzzi
1   Hospital Total Cor, São Paulo SP, Brasil;
,
Evelyn de Paula Pacheco
1   Hospital Total Cor, São Paulo SP, Brasil;
2   Hospital Paulistano, São Paulo SP, Brasil;
,
Renan Barros Domingues
1   Hospital Total Cor, São Paulo SP, Brasil;
2   Hospital Paulistano, São Paulo SP, Brasil;
,
Marco Pieruccetti
2   Hospital Paulistano, São Paulo SP, Brasil;
,
Luciano Marcus Tirotti Giacon
2   Hospital Paulistano, São Paulo SP, Brasil;
,
Jose Carlos Teixeira Garcia
1   Hospital Total Cor, São Paulo SP, Brasil;
,
Valter Furlan
1   Hospital Total Cor, São Paulo SP, Brasil;
,
Ayrton Roberto Massaro
3   Hospital Sírio Libanês, São Paulo SP, Brasil.
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A 50-year-old woman with recent myocardial infarction (MI), presented right hemiparesis with aphasia (National Institutes of Health Stroke Scale: 18), 24 hours after the coronary angiogram that revealed a large apical thrombus ([Figure 1A]). Computed tomography demonstrated left middle cerebral artery (MCA) “dot” sign ([Figure 1B]). Angiography showed occlusion in the MCA second segment ([Figure 1C]) with recanalization after mechanical thrombectomy ([Figure 1D]). She presented a complete recovery (Rankin: 0) and after 9 days she was discharged with oral anticoagulation. Recent MI within previous 3 months is a contraindication to IV thrombolysis (myocardial rupture)[1],[2]. Mechanical thrombolysis seems to be a safe and effective alternative in this situation[3],[4],[5].

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Figure 1 (A) Computed tomography demonstrated a left middle cerebral artery “dot” sign (arrowhead); (B) Coronary angiogram revealed an apical myocardial disfunction with a large thrombus; (C) Cerebral angiogram demonstrated an occlusion; (D) Recanalization after an endovascular procedure using a mechanical device (Penumbra system).


Publikationsverlauf

Eingereicht: 29. August 2015

Angenommen: 16. Mai 2016

Artikel online veröffentlicht:
06. September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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