Efficacy of endovascular recanalization for symptomatic non-acute occlusion of the M2 segment of the middle cerebral artery:a case report and literature review
Efficacy of endovascular recanalization for symptomatic non-acute occlusion of the M2 segment of the middle cerebral artery:a case report and literature review
Objective To investigate the clinical features,and endovascular treatment methods and outcomes of patients with symptomatic non-acute occlusion of the M2 segment of the middle cerebral artery(MCA).Methods The clinical data of one patient with symptomatic non-acute occlusion of the M2 segment of the MCA treated with endovascular recanalization was retrospectively analyzed,and the related literatures were recovered.Results A 65-year-old male with a history of hypertension for over 13 years and no regular use of antihypertensive drugs presented with recurrent acute cerebral infarction one week after thrombolytic therapy for the initial infarction.He had a motor power of 0 on the left side,an NIHSS score of 18,and an mRS score of 5 on admission.Head MRI showed multiple infarction lesions in the right cerebral hemisphere,head CTA showed occlusion of the right MCA,and cerebral perfusion imaging showed marked hypoperfusion in the right cerebral hemisphere.The angiography showed that the superficial and deep branches of the right MCA were occluded,while the pia mater branches of the anterior and posterior cerebral arteries supplied the territory of the MCA partially.After completing preoperative evaluation,endovascular recanalization of the M2 segment of the right MCA was performed.No intracranial hemorrhage was detected on immediate postoperative head CT.One month after the operation,the left lower limb had a motor power of 5,the left upper limb had a motor power of 3,and the mRS score was 2.Three years after the operation,the left lower limb had a motor power of 5,the left upper limb had a motor power of 4,and the mRS score was 1.Conclusions For patients with non-acute occlusion of the M2 segment of the MCA associated with severe symptoms,endovascular recanalization can be considered after thorough preoperative evaluation.
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