Öz
Stroke is an acute event that characterized as a neurological deficit related to injury of the central nervous system by a vascular cause. It’s separated in two groups as hemorrhagic stroke and ischemic stroke. Among the causes of ischemic stroke, prosedures such as percutaneous coronary interventions (PCI) beside of immobilization and coagulation disorders can be seen.
An 69-year-old female patient admitted to our emergency department with chest pain revealed anterior ST elevation myocardial infarction. 300 mg of acetylsalicylic acid, 180 mg of clopidogrel and 5000 IU of unfractionated heparin were loaded and the patient was taken to PCI at 15 minutes. The patient who developed dysarthria and 3/5 loss of motor function of the left extremities during PCI was diagnosed as procedural ischemic stroke. After 4 days of treatment with 100mg/day acetylsalicylic acid and 8000IU/day enoxaparin, the patient was discharged with dysarthria and 4/5 loss of motor function.
Anahtar Kelimeler
Kaynakça
- 1. Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An Updated Definition of Stroke for the 21st Century: A Statement for Healtcare Professionals From the American Heart Association/American Stroke Association. Stroke, 2013; 44(7):2064- 89.
- 2. Altun Y, Aydin I, Algin A. Demographic Characteristics of Stroke Types in Adiyaman/Adiyaman Ilinde Inme Tiplerinin Demografik Ozellikleri. Turkish Journal of Neurology, 2018; 24(1):26-32.
- 3. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association, Stroke, 2018; 49(3):46-99.
- 4. Tang XF, Gao Z, Xu JJ, Song Y, Ma YL, Wang HH, Jiang L, Jiang P, Liu R, Gao LJ, Zhang Y. Clinical characteristics and prognosis in the patients of stroke after percutaneous coronary intervention. Zhonghua yi xue za zhi. 2017 Oct 24;97(39):3051.
- 5. Abbott JD, Ahmed HN, Vlachos HA, Selzer F, Williams DO. Comparison of outcome in patients with ST-elevation versus non-ST-elevation acute myocardial infarction treated with percutaneous coronary intervention (from the National Heart, Lung, and Blood Institute Dynamic Registry). Am J Cardiol. 2007 Jul 15;100(2):190-5. Epub 2007 Jun 4.
- 6. Hamon M., Baron JC, Viader F, Hamon M. Periprocedural Stroke and Cardiac Catheterization. Circulation, 2008; 118(6):678-83.
- 7. Fujino A, Hao H, Shimodai S, Kawakami K, Matsuo K, Yasumura Y, et al. Atherosclerotic Plaque Component as a Risk Factor for Distal Embolization During Percutaneous Coronary Intervention ― Pathology of Tissue Obtained by Distal Protection Device ― .Circulation Journal, 2018; 82(9):2292-98.
- 8. Büsing KA, Schulte-Sasse C, Flüchter S, Süselbeck T, Haase KK, Neff W, et al. Cerebral Infarction: Incidence and Risk Factors after Diagnostic and Interventional Cardiac Catheterization—Prospective Evaluation at Diffusion-weighted MR Imaging. Radiology, 2005; 235(1), 177-83.
- 9. Shoji S, Kohsaka S, Kumamaru H, Sawano M, Shiraishi Y, Ueda I, et al. Stroke After Percutaneous Coronary Intervention in the Era of Transradial Intervention: Report From a Japanese Multicenter Registry. Circulation: Cardiovascular Interventions, 2018;11 (12):6761.
Öz
İnme, vasküler nedenli nörolojik defisit ile karakterize akut bir hadisedir. Hemorajik inme ve iskemik inme olarak 2 gruba ayrılır. İskemik inme nedenleri arasında immobilizasyon, koagülasyon bozuklukları vb. yanısıra perkütan koroner girişimler (PKG) gibi prosedürel işlemler de görülür.
Acil servisimize göğüs ağrısı ile başvuran 69 yaş bir kadın hastanın elektokardiyografisinde ST elevasyonlu anterior miyokard enfarktüsü bulguları tespit edildi. 300 mg asetilsalisilik asit, 180 mg klopidogrel ve 5000 IU iv unfraksiyone heparin yüklenen hasta 15. dakikada PKG alındı. PKG esnasında dizartri gelişen hastada prosedürel iskemik inme geçirmesi üzerine nöroloji ile konsulte edildi ancak nörolojinin ek antikoagülasyon önerileri olmadı.
Anahtar Kelimeler
Kaynakça
- 1. Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An Updated Definition of Stroke for the 21st Century: A Statement for Healtcare Professionals From the American Heart Association/American Stroke Association. Stroke, 2013; 44(7):2064- 89.
- 2. Altun Y, Aydin I, Algin A. Demographic Characteristics of Stroke Types in Adiyaman/Adiyaman Ilinde Inme Tiplerinin Demografik Ozellikleri. Turkish Journal of Neurology, 2018; 24(1):26-32.
- 3. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association, Stroke, 2018; 49(3):46-99.
- 4. Tang XF, Gao Z, Xu JJ, Song Y, Ma YL, Wang HH, Jiang L, Jiang P, Liu R, Gao LJ, Zhang Y. Clinical characteristics and prognosis in the patients of stroke after percutaneous coronary intervention. Zhonghua yi xue za zhi. 2017 Oct 24;97(39):3051.
- 5. Abbott JD, Ahmed HN, Vlachos HA, Selzer F, Williams DO. Comparison of outcome in patients with ST-elevation versus non-ST-elevation acute myocardial infarction treated with percutaneous coronary intervention (from the National Heart, Lung, and Blood Institute Dynamic Registry). Am J Cardiol. 2007 Jul 15;100(2):190-5. Epub 2007 Jun 4.
- 6. Hamon M., Baron JC, Viader F, Hamon M. Periprocedural Stroke and Cardiac Catheterization. Circulation, 2008; 118(6):678-83.
- 7. Fujino A, Hao H, Shimodai S, Kawakami K, Matsuo K, Yasumura Y, et al. Atherosclerotic Plaque Component as a Risk Factor for Distal Embolization During Percutaneous Coronary Intervention ― Pathology of Tissue Obtained by Distal Protection Device ― .Circulation Journal, 2018; 82(9):2292-98.
- 8. Büsing KA, Schulte-Sasse C, Flüchter S, Süselbeck T, Haase KK, Neff W, et al. Cerebral Infarction: Incidence and Risk Factors after Diagnostic and Interventional Cardiac Catheterization—Prospective Evaluation at Diffusion-weighted MR Imaging. Radiology, 2005; 235(1), 177-83.
- 9. Shoji S, Kohsaka S, Kumamaru H, Sawano M, Shiraishi Y, Ueda I, et al. Stroke After Percutaneous Coronary Intervention in the Era of Transradial Intervention: Report From a Japanese Multicenter Registry. Circulation: Cardiovascular Interventions, 2018;11 (12):6761.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Vaka Takdimi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 2 Sayı: 3 |
