| Thrombolytic therapy for ischemic stroke secondary to paradoxical embolism in pregnancy: a case report and literature review. | |
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MedLine Citation:
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PMID: 22217616 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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INTRODUCTION: : Thrombolysis for acute ischemic stroke has been rarely administrated during pregnancy. Paradoxical embolism through a patent foramen ovale (PFO) or pulmonary arteriovenous malformation (AVM) is an identified risk factor for ischemic stroke. CASE REPORT: : We report a 24-year-old woman at 11 weeks gestation who developed a sudden onset of dysarthria, hemiparesis, and hemisensory loss. She was diagnosed as having an ischemic stroke in the left middle cerebral artery (MCA) territory. She was treated with intra-arterial recombinant tissue plasminogen activator with subsequent resolution of her neurological deficits. Further workup revealed the presence of a PFO with a large right-to-left shunt. After being put on antithrombotic therapy, she presented again at 13 gestational weeks with a new ischemic infarction in the vertebrobasilar territory. Her PFO was closed percutaneously under ultrasonic guidance but the right-to-left shunt persisted. After a normal delivery, she was found to have a large pulmonary AVM which was successfully resected without complication. CONCLUSIONS: : This report describes the successful usage of intra-arterial tissue plasminogen activator for acute ischemic stroke during early pregnancy. In patients with presumed paradoxical embolism, careful attention should be paid to rule out a coexistence of PFO and pulmonary AVM. |
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Authors:
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Yuebing Li; John Margraf; Bryan Kluck; Donna Jenny; John Castaldo |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The neurologist Volume: 18 ISSN: 1074-7931 ISO Abbreviation: Neurologist Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-01-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9503763 Medline TA: Neurologist Country: United States |
Other Details:
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Languages: eng Pagination: 44-8 Citation Subset: IM |
Affiliation:
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Division of Neurology, Department of Medicine, The Lehigh Valley Health Network, Allentown, PA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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