A case report of acute ischemic stroke with middle cerebral artery occlusion caused by Takotsubo syndrome
10.3760/cma.j.cn113694-20241127-00765
- VernacularTitle:心肌球形综合征引起大脑中动脉闭塞性急性缺血性卒中1例
- Author:
Shiya ZHANG
1
;
Suqiu HUAN
1
;
Sheng ZHUANG
1
;
Guodong XIAO
1
;
Yongjun CAO
1
;
Shoujiang YOU
1
Author Information
1. 苏州大学附属第二医院神经内科，苏州215004
- Publication Type:Journal Article
- Keywords:
Stroke;
Takotsubo syndrome;
Reversible;
Embolism
- From:
Chinese Journal of Neurology
2025;58(8):869-873
- CountryChina
- Language:Chinese
-
Abstract:
Takotsubo syndrome is a transient, reversible syndrome characterized by acute regional dysfunction of the left ventricle, with symptoms resembling those of acute coronary syndrome. Takotsubo syndrome can lead to left ventricular thrombus formation, which may embolize and cause ischemic stroke. However, such cases are relatively rare. A case of acute ischemic stroke with middle cerebral artery occlusion caused by Takotsubo syndrome is reported in this article. The patient presented primarily with left-sided limb weakness. Cerebral angiography indicated occlusion of the right middle cerebral artery, and complete vascular recanalization was achieved after endovascular thrombectomy. Cranial magnetic resonance imaging indicated multiple infarctions in both the anterior and posterior circulations. Transthoracic echocardiography showed apical thrombus formation in the left ventricle and significantly reduced left ventricular systolic function. After a short course of anticoagulation combined with antiplatelet therapy, the apical thrombus resolved, and left ventricular systolic function significantly improved. This case indicates that although large-vessel occlusion acute ischemic stroke caused by Takotsubo syndrome is relatively rare, comprehensive etiological evaluation should be emphasized in patients with suspected cardioembolic stroke. Dynamic monitoring of echocardiographic changes is important for accurate diagnosis of the underlying cause.
