Clarion call for histopathological clot analysis in "cryptogenic" ischemic stroke: implications for diagnosis and treatment

被引：20

作者：

Bhaskar, Sonu ^{[1
,2
,3
,4
,5
,6
]}

Cordato, Dennis ^{[1
,4
,7
]}

Cappelen-Smith, Cecilia ^{[1
,4
,7
]}

Cheung, Andrew ^{[4
,8
,9
]}

Ledingham, David ^{[1
]}

Celermajer, David ^{[10
]}

Levi, Christopher ^{[1
,2
,3
,4
,5
,7
]}

机构：

[1] Liverpool Hosp, Dept Neurol & Neurophysiol, Liverpool, NSW, Australia

[2] Western Sydney Univ, Sch Med, South West Sydney Clin Sch, THRI, Sydney, NSW, Australia

[3] SPHERE, Sydney, NSW, Australia

[4] Ingham Inst Appl Med Res, Sydney, NSW, Australia

[5] John Hunter Hosp, Dept Neurol, Newcastle, NSW, Australia

[6] Univ Newcastle, Sch Med & Publ Hlth, Fac Hlth & Med, Callaghan, NSW, Australia

[7] Univ New South Wales, South Western Sydney Clin Sch, Sydney, NSW, Australia

[8] Liverpool Hosp, Dept Intervent Neuroradiol, Liverpool, NSW, Australia

[9] Prince Wales Hosp, Dept Intervent Neuroradiol, Randwick, NSW, Australia

[10] Univ Sydney, Heart Res Inst, Royal Prince Alfred Hosp, Dept Cardiol, Sydney, NSW, Australia

来源：

ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY | 2017年 / 4卷 / 12期

关键词：

INFECTIVE ENDOCARDITIS; EMBOLIC EVENTS; ASPIRIN; TRIAL; THROMBECTOMY;

D O I：

10.1002/acn3.500

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Diagnosis, treatment, and secondary management of cryptogenic stroke patients pose a formidable challenge. The scenario is further complicated in patients with native and prosthetic valvular heart disease. We present a case study of a 36-year-old man who received intravenous thrombolysis (IV-tPA) and endovascular thrombectomy (EVT) for presumed "cryptogenic" complete middle cerebral artery infarction who made a surprisingly excellent clinical recovery despite poor baseline and postintervention neuroimaging. Retrospective gram stain of his clot confirmed a diagnosis of infective endocarditis. This raises an important issue regarding need for more routine histopathological analysis of clot retrieved after EVT in "cryptogenic" stroke patients particularly those with valvular heart disease.

引用

页码：926 / 930

页数：5

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