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case 10  

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ossama yassin mansour
(@admin)
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Joined: 2 years ago
Posts: 10
17/02/2018 7:49 pm  

57-year-old woman with a left chronic discoloration of the iris and the other ocular manifestation shown in the pic (taken from his ID) .

According relative history the patient has DM, HTN, IHD, while the ocular findings dated to birth.

Patient came to our hospital due to acute onset of aphasia started 4 hours before presentation
Perfusion image showed mismatch

Due to late presentation beyond 3.5 hours patient shifted to Cath lab where the following was apparent ????

Lt CCA injection

RT ICA injection 

so we not sure about presence of Acom so we decided to inject TPA IA from Post circulation through leptomeningeal collaterals from Lt PCA

Microcatheter in Lt PCA during IA -rtpa injection 

Basilar injection after recanalization   

final Rt ICA injection after recanalization 

( look at disappearance of previously apparent inter cavernous anastomosis )

CT bone window and 3d bone axial proving the absence of carotid canal

 

Question for discussion is there any EBM for IA-Thrombolysis ?


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