Abstract：
Early recurrent ischemic stroke (ERIS), as well as symptomatic intracranial hemorrhage (SICH) and progressive stroke (PS), causes early neurological deterioration. Here we report a case of a patient with right internal carotid artery (ICA) occlusion immediately after intravenous recombinant tissue plasminogen activator (rt-PA) treatment for left middle cerebral artery (MCA) occlusion. A 79-year-old woman with drowsiness, aphasia and right hemiparesis was brought to our hospital. MRI showed acute infarction in the left internal capsule and occlusion of the left middle cerebral artery. rt-PA was administered intravenously to the patient 2 hours after the onset of the event. Her consciousness disturbance and aphasia improved, but the right hemiparesis did not. We performed emergent endovascular thrombectomy, but the right ICA (cervical portion) was occluded during the surgery. Finally, the endovascular thrombectomy achieved the recanalization of the left MCA and right ICA. When performing intravenous thrombolysis, we should beware the possibility of re-occlusion and prepare for interventional treatment.
摘要：
早期复发性缺血性卒中(ERIS),以及症状性颅内出血（SICH）和进展性卒中（PS），导致早期神经系统恶化。在这里，我们报告了一例在静脉重组组织纤溶酶原激活剂（rt-PA）治疗左大脑中动脉（MCA）闭塞后立即患有右颈内动脉（ICA）闭塞的患者。一个79岁的睡意女人,失语和右偏瘫被带到我们医院。MRI显示左侧内囊急性梗死，左侧大脑中动脉闭塞。在事件发生后2小时对患者静脉内施用rt-PA.她的意识障碍和失语症得到了改善，但右偏瘫没有.我们进行了紧急血管内血栓切除术,但右侧ICA（宫颈部分）在手术过程中被闭塞。最后,血管内血栓切除术实现了左MCA和右ICA的再通。进行静脉溶栓时，我们应该提防再次闭塞的可能性，并为介入治疗做好准备。
