1.Successful Endovascular Mechanical Thrombolysis in a Patient with Hyperacute Tandem Occlusions of Middle Cerebral Artery and Extracranial Internal Carotid Artery.
Dong Woo RYU ; Si Baek LEE ; Siryung HAN ; Bum Soo KIM ; Hyung Eun PARK ; Dae Woong BAE ; Jaseong KOO
Korean Journal of Stroke 2011;13(3):147-151
Previous studies have shown that patients with tandem occlusions involving extracranial internal carotid artery (ICA) and middle cerebral artery (MCA) have lower likelihood of recanalization by standard intravenous thrombolytic therapy. A 70-years-old man with a history of hypertension was admitted because of left hemiplegia and drowsiness which developed 47 minutes ago. On neurologic examination, he was drowsy and showed neglect syndrome as well as left hemiplegia. Brain CT angiography showed tandem occlusions at right extracranial ICA and proximal MCA. The administration of intravenous (IV) tissue plasminogen activator (tPA) did not improve his symptoms. We performed angioplasty and stenting for proximal ICA occlusion followed by mechanical thrombolysis for MCA occlusion. After the endovascular treatment, the MCA was recanalized and the patient recovered to show only mild left side weakness. This case shows successful treatment of hyperacute ischemic infarction from tendem occlusion of right MCA and proximal ICA with endovascular treatment following IV tPA thrombolysis.
Angiography
;
Angioplasty
;
Brain
;
Carotid Artery, Internal
;
Cerebral Infarction
;
Hemiplegia
;
Humans
;
Hypertension
;
Infarction
;
Mechanical Thrombolysis
;
Middle Cerebral Artery
;
Neurologic Examination
;
Sleep Stages
;
Stents
;
Thrombolytic Therapy
;
Tissue Plasminogen Activator
2.Neuromyelitis optica spectrum disorder in a patient with spinocerebellar ataxia type 6
Siryung Han ; Dae Woong Bae ; Jae Young An
Neurology Asia 2019;24(4):377-379
Spinocerebellar ataxia type 6 (SCA6) is an autosomal dominant, late-onset, slowly progressive
cerebellar ataxia due to a pathological CAG repeat expansion in CACNA1A. Inflammation may be
involved in the pathogenesis and progression of the trinucleotide repeat expansion disorder. We report
a rare case of a 59-year-old woman with SCA6 who developed neuromyelitis optica spectrum disorder
(NMOSD). In our case, this combination is coincidental but suggests that an inflammatory response
to an unstable CAG repeat may contribute to NMOSD pathogenesis