Thrombolysis for acute stroke in patient with systemic lupus erythematosus: A case report

Majdak, Maja Rubinić; Vuletić, Vladimira

doi:10.1016/j.jns.2015.12.014

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Thrombolysis for acute ischaemic stroke has been performed in patients with SLE with success, but no consensus recommendations are made; however, the use of advanced vascular neuroimaging may be useful to rule out aneurysms. 48 In acute larger strokes, combining endovenous and intra-arterial recombinant tissue plasminogen activator (rt-PA) may be used with caution. Furthermore, in cases in which aPL is also present, the use of stents and prolonged post-procedure maintenance with glycoprotein (GP)IIb/IIIa receptor antagonists may be an alternative, since recurrent stroke may occur during the intra-arterial procedure.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Stroke in systemic lupus erythematosus and antiphospholipid syndrome: risk factors, clinical manifestations, neuroimaging, and treatment

Amorim

Maia

Rodrigues

2017

Lupus

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Neurologic disorders are among the most common and important clinical manifestations associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), mainly those that affect the central nervous system (CNS). Risk of cerebrovascular events in both conditions is increased, and stroke represents one of the most severe complications, with an incidence rate between 3% and 20%, especially in the first five years of diagnosis. This article updates the data regarding the risk factors, clinical manifestations, neuroimaging, and treatment of stroke in SLE and APS.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Stroke in systemic lupus erythematosus and antiphospholipid syndrome: risk factors, clinical manifestations, neuroimaging, and treatment

Amorim

Maia

Rodrigues

2017

Lupus

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“…The outcome of AIS improved a lot since the intervention of alteplase, which is also widely used in SLErelated AIS and prevent re-occlusion. [6][7][8] With the improvement of stent retriever, endovascular treatment was proved to be effective since MR CLEAN trial, and MT is the first-line treatment for the AIS patients with large vessel occlusion (LVO). [9] With the advances in imaging, the paradigm shift of early management of AIS was changing from "time is brain" to "image is brain."…”

Section: Discussionmentioning

confidence: 99%

“…This was the first case of SLE-related ischemic stroke treated by MT and she lives independently (modified rankin scale scored 1). The outcome of AIS improved a lot since the intervention of alteplase, which is also widely used in SLE-related AIS and prevent re-occlusion [6–8] . With the improvement of stent retriever, endovascular treatment was proved to be effective since MR CLEAN trial, and MT is the first-line treatment for the AIS patients with large vessel occlusion (LVO) [9] .…”

Section: Discussionmentioning

confidence: 99%

Perfusion image guided mechanical thrombectomy combined with tirofiban successfully revascularize systemic lupus erythematosus related acute large vessel occlusion

Wang

Hu²,

et al. 2021

Medicine

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Rationale: Systemic lupus erythematosus (SLE) is an important cause of stroke, more than a half the cases present as acute ischemic stroke. Thrombolysis is an effective choice in most cases, but for large vessel occlusion, mechanical thrombectomy is more effective. Here we reported a case of SLE-related stroke with left middle cerebral artery (MCA) occlusion, who was successfully treated by MT and tirofiban. Patient concern: A 38-year-old female suffered from right hemiplegia and aphasia for 8 hours. She was diagnosed with SLE 20 years ago, and neuropsychiatric SLE was considered 8 months before this onset. One month ago, glucocorticoids were discontinued by herself because of deterioration of bilateral femoral head osteonecrosis. Diagnosis: Left MCA occlusion was confirmed by computed tomography perfusion. Intervention: Immediate mechanical thrombectomy was performed and tirofiban was given to prevent re-occlusion of left MCA. Twenty fourhours later oral antiplatelet was given after intracranial hemorrhage was ruled out. Outcomes: Her neurological symptom improved several days later, and she was transferred to further rehabilitation. At 4 months follow-up she can live independently with mild hypophrasia. There was no further events of ischemic stroke in 1-year follow-up. Lessons: Mechanical thrombectomy is a highly effective and indispensable treatment for SLE related large vessel occlusion. In addition, tirofiban may reduce vessel reocclusion in special cases such as SLE and artery stenosis.

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“…Svarbus radiologinis tyrimas [2]. Aprašytas ūminio išeminio insulto gydymas trombolize ligoniui, sergančiam SRV [31]. Apie insulto dėl arterijų trombozės gydymą yra labai nedaug duomenų.…”

Section: Literatūros Apžvalga Ir Diskusijaunclassified

Sisteminės Raudonosios Vilkligės Neurologinės Komplikacijos

Kimševaitė¹

2022

Health Sciences

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Straipsnyje analizuojamos sisteminės raudonosios vilkligės neurologinės komplikacijos. Galvos smegenų kraujotakos sutrikimai, galvos skausmas ir traukuliai yra dažniausios sisteminės raudonosios vilkligės neurologinės komplikacijos. Insultas yra pagrindinė sergančiųjų sistemine raudonąja vilklige sergamumo, mirštamumo ir negalios priežastis. Jaunų asmenų, ypač moterų, išeminis insultas visada turėtų kelti sisteminės raudonosios vilkligės įtarimą. Sisteminę raudonąją vilkligę reikia įtarti ir ligoniams, sergantiems cerebrinių veninių sinusų tromboze. Epilepsiniai priepuoliai dažnesni pirmaisiais sisteminės raudonosios vilkligės metais. Nustatytas didelis sergančiųjų sistemine raudonąja vilklige epilepsijos paplitimas, susijęs su galvos smegenų kraujagyslių ligomis, antifosfolipidiniu sindromu ir psichozėmis. Epilepsinių priepuolių pasikartojimas susijęs su antifosfolipidiniu sindromu. Meningitas, parkinsonizmas ir mielopatija yra retos sisteminės raudonosios vilkligės komplikacijos. Kognityvinė disfunkcija dažna sergant sistemine raudonąja vilklige, ji neigiamai veikia sergančiųjų socialinį funkcionavimą. Migrena yra dažna ligoniams, sergantiems sistemine raudonąja vilklige. Ji nesusijusi su sisteminės raudonosios vilkligės aktyvumu, galvos MRT ir likvoro pokyčiais. Galvos skausmo, sąlygoto sisteminės raudonosios vilkligės, gydymas yra empirinis, pagrįstas klinikine patirtimi. Polineuropatija yra dažniausia sergančiųjų sistemine raudonąja vilklige periferinės nervų sistemos komplikacija. Periferinė neuropatija dažniau pasireiškia ligoniams, sergantiems aktyvia sisteminės raudonosios vilkligės forma. IgG kiekio padidėjimas yra periferinės neuropatijos rizikos veiksnys, sergant sistemine raudonąja vilklige. Guillain-Barré sindromas gali būti pirminė klinikinė sisteminės raudonosios vilkligės apraiška. Kortikosteroidai yra pirmo pasirinkimo vaistai, gydant neurologines uždegimines sisteminės raudonosios vilkligės komplikacijas. Ūminis išeminis insultas, susijęs su sisteminės raudonosios vilkligės vaskulitu, gali būti sėkmingai gydomas intravenine trombolize. Straipsnyje pateikti klinikiniai sisteminės raudonosios vilkligės neurologinių komplikacijų atvejai. Apžvelgta naujausia mokslinė literatūra apie sisteminės raudonosios vilkligės neurologines komplikacijas.

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Thrombolysis for acute stroke in patient with systemic lupus erythematosus: A case report

Cited by 5 publications

References 6 publications

Stroke in systemic lupus erythematosus and antiphospholipid syndrome: risk factors, clinical manifestations, neuroimaging, and treatment

Stroke in systemic lupus erythematosus and antiphospholipid syndrome: risk factors, clinical manifestations, neuroimaging, and treatment

Perfusion image guided mechanical thrombectomy combined with tirofiban successfully revascularize systemic lupus erythematosus related acute large vessel occlusion

Sisteminės Raudonosios Vilkligės Neurologinės Komplikacijos

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