Background: Cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy is characterized by high morbidity, disability and mortality. If the patient also has severe pulmonary embolism (PE) at the same time, the treatment becomes more complex. This report describes the treatment strategy for a patient with PE and cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy.
Case summary: A 70-year-old woman presented to our emergency department with right-sided hemiplegia and mixed aphasia of 2.5 h duration. She was diagnosed with left cerebral embolism, left internal carotid artery occlusion, PE and left calf intramuscular vein thrombosis. Following mechanical thrombectomy, brain magnetic resonance imaging showed cerebral infarction with basal ganglia hemorrhage. We observed changes in cerebral hemorrhage on serial monitoring of brain computed tomography and adjusted the dose of anticoagulant drugs. After 3 wk of treatment, the patient's neurological and respiratory symptoms significantly improved, and a favorable prognosis was obtained.
Conclusion: Anticoagulation could be a potential option for PE accompanied by hemorrhagic transformation of an ischemic infarct.
Keywords: Anticoagulation; Brain embolism; Case report; Cerebral hemorrhage; Mechanical thrombectomy; Pulmonary embolism.
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