Convexity subarachnoid hemorrhage after mechanical thrombectomy.

BACKGROUND

The occurrence and impact of acute convexity subarachnoid hemorrhage (cSAH) in patients with acute ischemic stroke (AIS) caused by intracranial atherosclerotic (ICAS)-related large vessel occlusion (LVO) who underwent mechanical thrombectomy (MT) have rarely been reported.

METHODS

AIS patients with ICAS-related LVO who experienced acute cSAH after MT were enrolled. Data on demographic, baseline clinical information, perioperative radiological images, treatment, and prognosis of the patients were extracted and reviewed. The modified Rankin scale (mRS) score at 90 days was used to assess the prognosis, and an mRS score of 0-2 was considered to indicate a good prognosis.

RESULTS

Among 979 patients with acute ICAS-related LVO who underwent MT, 9 (0.92%) patients experienced cSAH (7 men, mean age 58 years). 4 (4/9, 44%) of patients were prescribed dual antiplatelet therapy while 5 (5/9, 56%) were prescribed single antiplatelet therapy for postoperative management. None of the patients experienced transformation to intracerebral hemorrhage. At 90 days, all nine patients (100%) had a good prognosis.

CONCLUSION

Our study showed that cSAH rarely occurs after MT in AIS patients with ICAS-related occlusion, and its occurrence does not appear to influence antiplatelet administration or patient prognosis.