A Case of Intravascular Treatment for Acute Ischemic Stroke with Internal Carotid Artery Stenosis That Developed While Driving.

OBJECTIVE

We report a case of acute cerebral infarction that may have been associated with high-energy trauma due to onset while driving.

CASE PRESENTATION: A 67-year-old man had a traffic accident. His neurological symptoms were left hemiplegia and contrast CT revealed right middle cerebral artery occlusion. Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) and intravascular treatment were performed. Right carotid artery angiography demonstrated internal carotid artery stenosis. Middle cerebral artery (MCA) revascularization was performed only by percutaneous transluminal angioplasty (PTA) of the internal carotid artery. Thoracic hemorrhage was observed a few hours after surgery, and hemostasis was performed by thoracotomy. Carotid artery stenting (CAS) was performed 8 days after onset. The patient was transferred to a convalescent rehabilitation hospital.

CONCLUSION

Rt-PA and acute CAS were not recommended for cerebral infarction due to traffic accident.