Objective: We report a case of acute cerebral ischemia with tandem lesion in a patient who underwent emergent carotid artery stenting (CAS) and intracranial thrombectomy. Case presentation: A 59-year-old female suffering from aphasia and right hemiparesis was taken in ambulance, 78 minutes later from acute onset. National Institute of Health Stroke Scale was 25. Diffusion-weighted image (DWI) MRI showed acute infarction at left insula cortex, basal ganglia and frontal lobe, and MRA showed left internal carotid artery (ICA) occlusion. Clinical-DWI mismatch was admitted, we performed interventional therapy. DSA showed not only left intracranial ICA occlusion but also left cervical ICA severe stenosis. We placed carotid wallstent at cervical ICA stenosis site. After CAS, we performed thrombectomy for intracranial ICA, and gained complete recanalization. Postinterventional course was uneventful. Right hemiparesis was dramatically improved but motor aphasia was remained at discharge. Conclusion: We reported a case of acute cerebral infarction with tandem lesion leading to improving neurological deficits by CAS and thrombectomy. Interventional therapy for tandem lesion was useful.
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