Acute ischemic stroke in a third trimester of pregnancy – cesarean section followed by mechanical thrombectomy

Abstract

Background: Acute ischemic stroke (AIS) in pregnancy, despite being a rare event, poses a serious risk for mother’s and child’s health. There are no strict treatment guidelines in this group of patients, with safety and efficacy of intravenous recombinant tissue-plasminogen-activator (rtPA) and mechanical thrombectomy (MT) being uncertain.

Case Presentation: We present a case of gravid 27-year-old patient with left middle cerebral artery (MCA) proximal occlusion causing AIS that was successfully treated with MT. Being in 35^th gestational week, it was decided to perform caesarean section before endovascular treatment. The outcome of treatment was good, with no mother’s neurological deficit and proper child development in the 5-year observation.

Conclusions: MT is probably safe and efficient treatment method in selected pregnant women. No harmful effects on further pregnancy course and parturition have been observed to date.

Keywords:

• Mechanical thrombectomy
• acute ischemic stroke
• pregnancy
• endovascular treatment

Disclosure statement

The authors report no conflict of interest.