Two Cases of Posterior Cerebral Artery P2 Segment Occlusion with Motor Weakness Improved by Acute Mechanical Thrombectomy

Hidekazu Yamazaki; Masafumi Morimoto; Chiyoe Hikita; Mitsuhiro Iwasaki; Maeda Masahiro; Yasufumi Inaka; Shinya Fukuta; Hiroaki Sato; Jyunpei Nagasawa

doi:10.1016/j.wneu.2020.06.085

Two Cases of Posterior Cerebral Artery P2 Segment Occlusion with Motor Weakness Improved by Acute Mechanical Thrombectomy

World Neurosurg. 2020 Oct:142:13-16. doi: 10.1016/j.wneu.2020.06.085. Epub 2020 Jun 17.

Authors

Hidekazu Yamazaki¹, Masafumi Morimoto², Chiyoe Hikita², Mitsuhiro Iwasaki², Maeda Masahiro², Yasufumi Inaka², Shinya Fukuta², Hiroaki Sato², Jyunpei Nagasawa³

Affiliations

¹ Department of Neurology and Neuroendovascular Treatment, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan. Electronic address: hidekazu.y0815@gmail.com.
² Department of Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan.
³ Department of Neurology and Neuroendovascular Treatment, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan.

PMID: 32562904
DOI: 10.1016/j.wneu.2020.06.085

Abstract

Background: Clinical evidence to support the use of mechanical thrombectomy (MT) for posterior cerebral artery P2 segment occlusion (P2O) has not been established, and hemiplegia due to P2O improved by MT to our knowledge has not yet been reported. We report 2 cases of P2O with hemiplegia improved by MT.

Case description: In case 1, a 68-year-old man was admitted with right hemiplegia and dysesthesia (National Institutes of Health Stroke Scale score 14). Head magnetic resonance imaging showed acute ischemia in the left inferolateral thalamus and posterior limb of the internal capsule. Angiography showed left P2O, which was recanalized after MT. Hemiplegia improved immediately following recanalization, and modified Rankin Scale score at discharge was 0. In case 2, a 69-year-old man was admitted with left hemiplegia and dysesthesia (National Institutes of Health Stroke Scale score 8). Head magnetic resonance imaging showed acute ischemia in the right inferolateral thalamus and posterior limb of the internal capsule. Angiography showed right P2O, which was recanalized after MT, as in case 1. His symptoms resolved completely.

Conclusions: P2O may cause severe motor deficit. In such cases, MT may contribute to safely improving patients' deficits.

Keywords: Acute mechanical thrombectomy; Motor weakness; Posterior cerebral artery occlusion.

Publication types

Case Reports

MeSH terms

Aged
Cerebrovascular Disorders / complications
Cerebrovascular Disorders / diagnostic imaging
Cerebrovascular Disorders / surgery*
Humans
Male
Muscle Weakness / diagnostic imaging
Muscle Weakness / etiology
Muscle Weakness / surgery*
Posterior Cerebral Artery / diagnostic imaging
Posterior Cerebral Artery / surgery*
Thrombectomy / methods*