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A Pregnant Case on which EC-IC Bypass was Successfully Performed in the Acute Phase of Brain Infarction Toshiro KATSUTA 1 , Akiko KANATA 1 , Kimitaka NAKAMURA 1 , Haruhisa TSUKAMOTO 1 , Yukiko TAZAKI 2 , Shoko HIRAKAWA 2 , Shusaku INOUE 2 , Takeshi TAKASHIMA 2 1Department of Neurosurgery,Kitakyushu Municipal Medical Center 2Department of Obstetrics and Gynecology,Kitakyushu Municipal Medical Center Keyword: pregnancy , brain infarction , EC-IC bypass , progressing stroke , acute revascularization pp.181-186
Published Date 2012/2/10
DOI https://doi.org/10.11477/mf.1436101656
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 A 30 year-old,28 weeks-pregnant woman (gravida 2,para 2) suffered from a sudden onset of aphasia when she was having a chat in the upright position. Although the initial symptom soon disappeared,transient attacks of aphasia combined with weakness in the right arm occurred intermittently,particularly when she uprose. MR image disclosed a small acute infarcted focus at the genu of the left internal capsule,while MRA showed an occlusion of the intracranial portion of the left internal carotid artery. She was treated conservatively,but the transient attack continued and her consciousness was slightly lowered. Since repeated examination revealed no recanalization of the occluded artery,treatment was reinforced by using heparin and dopamine on day 1. However,her consciousness was not improved,and dopamine evoked nausea and vomiting. On day 2,superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was carried out. Soon after surgery,she regained alertness and the transient attack subsided. Examinations could not clarify the course of the occlusion. She was treated with heparin until she delivered a sound baby in the 37th week. Although STA-MCA anastomosis for acute ischemic stroke is still debatable,it may be a good option even for a pregnant woman when suffering from intractable progressing stroke.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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