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Intraluminal carotid thrombus leading to postpartum stroke: a case study.

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Title: Intraluminal carotid thrombus leading to postpartum stroke: a case study.
Authors: Poggetti, Francesca (AUTHOR), Schwarz, Ghil (AUTHOR), Piano, Mariangela (AUTHOR), Gatti, Antonella (AUTHOR), Aquilano, Maria Costanza (AUTHOR), Di Como, Martina (AUTHOR), Protti, Alessandra (AUTHOR), Bonoldi, Emanuela (AUTHOR), Agostoni, Elio Clemente (AUTHOR), Cascio Rizzo, Angelo (AUTHOR)
Source: Neurological Sciences. Apr2024, Vol. 45 Issue 4, p1735-1739. 5p.
Subjects: Thrombosis, Aspirin, Endovascular surgery, Arterial dissections, Ischemic stroke, Atherosclerosis, Atherosclerotic plaque
Abstract: Background: Intraluminal non-occlusive thrombus (ILT) is a rare cause of ischemic stroke. Although in most cases ILT is associated with arterial wall disorders, it has also been documented in patients with thrombophilic conditions. Case report: We present a case of carotid ILT in a 38-year-old puerperal woman with pregnancy-induced hypercoagulability. Following in vitro fertilization pregnancy, she experienced acute left-sided weakness 9 days after delivery. CT angiography revealed an intraluminal filling defect in the right carotid bulb, suggestive of a thrombus, along with ipsilateral MCA sub-occlusion. Mechanical thrombectomy was performed, achieving complete vessel recanalization without any endovascular intervention on the carotid ILT. Comprehensive evaluation excluded any underlying carotid vessel wall disease (such as atherosclerosis, inflammatory diseases, arterial dissection, focal dysplasia), inherited or acquired thrombophilia, and the sole prothrombotic risk factor identified was the puerperium. Histological thrombus analysis showed fibrin/platelet-rich material with significant macrophage infiltration (consistent with an intermediate/organized thrombus, suggesting potential embolization from a pre-existing carotid ILT). Anti-thrombotic treatment (acetylsalicylic acid 100 mg and enoxaparin 6000 UI) resulted in complete thrombus resolution at follow-up. Conclusion: ILT should be considered a potential case of embolic stroke in pregnancy or puerperium. Vessel imaging is essential for diagnosis. Histological thrombus analysis can provide insights into the pathophysiological mechanisms of stroke. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Intraluminal carotid thrombus leading to postpartum stroke: a case study.
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  Data: <searchLink fieldCode="AR" term="%22Poggetti%2C+Francesca%22">Poggetti, Francesca</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schwarz%2C+Ghil%22">Schwarz, Ghil</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Piano%2C+Mariangela%22">Piano, Mariangela</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gatti%2C+Antonella%22">Gatti, Antonella</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aquilano%2C+Maria+Costanza%22">Aquilano, Maria Costanza</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Di+Como%2C+Martina%22">Di Como, Martina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Protti%2C+Alessandra%22">Protti, Alessandra</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bonoldi%2C+Emanuela%22">Bonoldi, Emanuela</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Agostoni%2C+Elio+Clemente%22">Agostoni, Elio Clemente</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cascio+Rizzo%2C+Angelo%22">Cascio Rizzo, Angelo</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Apr2024, Vol. 45 Issue 4, p1735-1739. 5p.
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  Data: <searchLink fieldCode="DE" term="%22Thrombosis%22">Thrombosis</searchLink><br /><searchLink fieldCode="DE" term="%22Aspirin%22">Aspirin</searchLink><br /><searchLink fieldCode="DE" term="%22Endovascular+surgery%22">Endovascular surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Arterial+dissections%22">Arterial dissections</searchLink><br /><searchLink fieldCode="DE" term="%22Ischemic+stroke%22">Ischemic stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Atherosclerosis%22">Atherosclerosis</searchLink><br /><searchLink fieldCode="DE" term="%22Atherosclerotic+plaque%22">Atherosclerotic plaque</searchLink>
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  Data: Background: Intraluminal non-occlusive thrombus (ILT) is a rare cause of ischemic stroke. Although in most cases ILT is associated with arterial wall disorders, it has also been documented in patients with thrombophilic conditions. Case report: We present a case of carotid ILT in a 38-year-old puerperal woman with pregnancy-induced hypercoagulability. Following in vitro fertilization pregnancy, she experienced acute left-sided weakness 9 days after delivery. CT angiography revealed an intraluminal filling defect in the right carotid bulb, suggestive of a thrombus, along with ipsilateral MCA sub-occlusion. Mechanical thrombectomy was performed, achieving complete vessel recanalization without any endovascular intervention on the carotid ILT. Comprehensive evaluation excluded any underlying carotid vessel wall disease (such as atherosclerosis, inflammatory diseases, arterial dissection, focal dysplasia), inherited or acquired thrombophilia, and the sole prothrombotic risk factor identified was the puerperium. Histological thrombus analysis showed fibrin/platelet-rich material with significant macrophage infiltration (consistent with an intermediate/organized thrombus, suggesting potential embolization from a pre-existing carotid ILT). Anti-thrombotic treatment (acetylsalicylic acid 100 mg and enoxaparin 6000 UI) resulted in complete thrombus resolution at follow-up. Conclusion: ILT should be considered a potential case of embolic stroke in pregnancy or puerperium. Vessel imaging is essential for diagnosis. Histological thrombus analysis can provide insights into the pathophysiological mechanisms of stroke. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Apr2024
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