PT  - JOURNAL ARTICLE
AU  - Scullen, Tyler
AU  - Milburn, James
AU  - Mathkour, Mansour
AU  - Amenta, Peter S.
TI  - Endovascular Mechanical Thrombectomy for Right Hemispheric Stroke Syndrome Due to Acute Left A1-A2 Junction Thromboembolic Occlusion
AID  - 10.31486/toj.23.0042
DP  - 2023 Dec 21
TA  - Ochsner Journal
PG  - 347--352
VI  - 23
IP  - 4
4099  - http://www.ochsnerjournal.org/content/23/4/347.short
4100  - http://www.ochsnerjournal.org/content/23/4/347.full
SO  - Ochsner J2023 Dec 21; 23
AB  - Background: Endovascular mechanical thrombectomy (EVT) for large vessel occlusions has had a dramatic impact on the management of acute ischemic stroke. Extended use of EVT beyond American Heart Association guidelines has been successful in carefully selected cases.Case Report: A 71-year-old male presented to our comprehensive stroke center upon awakening with mild left hemiparesis. He was found to have a chronic occlusion of the right supraclinoid segment of the internal carotid artery. Angiography demonstrated large vessel occlusion of the contralateral A1-A2 junction that was successfully recanalized. Imaging at 24 hours displayed no evidence of infarct, the patient rapidly improved during hospitalization, and he was discharged on postoperative day 7 with a National Institutes of Health Stroke Scale score of zero.Conclusion: We describe successful EVT of a patient presenting with false-localizing symptoms consistent with a right hemispheric acute ischemic stroke secondary to left A1-A2 junction large vessel occlusion. This case demonstrates the importance of a high index of suspicion when evaluating atypical stroke presentations and the effectiveness of EVT in the treatment of distal small-caliber vessels.