Mechanical Thrombectomy for Acute Right Hemiparesis and Aphasia

Background

A 20 year male presented to ER with complaints of right upper limb and lower limb weakness with a deviation of the mouth towards left, loss of speech and decreased comprehension since 5 hours of duration. At the time of presentation, NIHSS scale – 16 right side power 0 /5.

Diagnosis And Treatment:

CT angio of neck and brain showed left M1 (MCA) occlusion with left insular cortex hypodensity and intra luminal floating thrombus in aortic arch extending to the right bracheocephalic region.

A mechanical thrombectomy was performed on the patient within one hour of presentation. 24 hours post procedure, the patient showed dramatic improvement clinically with regain of power of 4/5 in right upper and lower limbs and NHSS score improving to 8.

Repeat CT brain was done which showed left MCA territory infarct.

Retrieved thrombus

About Author –

Dr. Vikas Agarwal, Sr. Consultant Neurologist, Yashoda Hospital, Hyderabad
MD, DM (AIIMS)

About Author –

Dr. Suresh Giragani, Consultant Neuro & Interventional Radiologist, Yashoda Hospitals – Hyderabad
MD (Radiology), DM (Neuroradiology)

Specialized in the comprehensive and widest range of vascular interventions covering neuro interventions, hepatobiliary interventions, venous, peripheral vascular interventions and interventions in cancer care.