Halil Onder1, E Murat Arsava1, Anıl Arat2, M Akif Topcuoglu1. 1. Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey. 2. Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey.
Abstract
OBJECTIVE: Experience on thrombolysis and/or thrombectomy for acute major ischemic strokes in the setting of deep (less than 40,000/mm(3)) thrombocytopenia is limited. METHODS: Case report and review of the literature. RESULTS: A 63-year-old female with myelodysplastic syndrome presented with left middle cerebral artery stroke within 2 hours of symptom onset. Severe thrombocytopenia (10.000/mm(3)) precluded systemic thrombolysis. However, endovascular thrombectomy provided successful recanalization and dramatic clinical recovery with NIHSS score decreasing from 20 to 2 soon after the procedure. Her modified Rankin scale was 1 at the end of the third month. CONCLUSION: This exceptional case highlights that neurothrombectomy could be feasible and of justifiable merit even in the setting of critically low thrombocytopenia if a meticulous procedure is followed in subjects with severe acute stroke.
OBJECTIVE: Experience on thrombolysis and/or thrombectomy for acute major ischemic strokes in the setting of deep (less than 40,000/mm(3)) thrombocytopenia is limited. METHODS: Case report and review of the literature. RESULTS: A 63-year-old female with myelodysplastic syndrome presented with left middle cerebral artery stroke within 2 hours of symptom onset. Severe thrombocytopenia (10.000/mm(3)) precluded systemic thrombolysis. However, endovascular thrombectomy provided successful recanalization and dramatic clinical recovery with NIHSS score decreasing from 20 to 2 soon after the procedure. Her modified Rankin scale was 1 at the end of the third month. CONCLUSION: This exceptional case highlights that neurothrombectomy could be feasible and of justifiable merit even in the setting of critically low thrombocytopenia if a meticulous procedure is followed in subjects with severe acute stroke.
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