Takotsubo cardiomyopathy following mechanical thrombectomy for acute ischemic stroke: illustrative case

• Published in: Journal of Neurosurgery: Case Lessons Vol. 2; no. 9; p. CASE21372
• Main Authors: Yamasaki, Tomohiro, Hayashi, Kentaro, Shibata, Yohei, Furuta, Tatsuya, Yamamoto, Kazuhiro, Uchimura, Masahiro, Fujiwara, Yuta, Nakagawa, Fumio, Kambara, Mizuki, Yoshikane, Tsutomu, Nagai, Hidemasa, Akiyama, Yasuhiko, Tanabe, Kazuaki, Tanabe, Junya
• Format: Journal Article
• Language: English
• Published: United States Journal of Neurosurgery Publishing Group (JNSPG) 30.08.2021; American Association of Neurological Surgeons
• Subjects: Case Lesson; mechanical thrombectomy; SAH = subarachnoid hemorrhage; takotsubo cardiomyopathy; acute ischemic stroke; MCA = middle cerebral artery; MR = magnetic resonance; ICA = internal carotid artery; MRI = magnetic resonance imaging
• ISSN: 2694-1902; 2694-1902
• DOI: 10.3171/case21372

Excess neurological stress by hemorrhagic stoke induces cardiomyopathy, namely takotsubo cardiomyopathy. Here, the authors report a case of takotsubo myopathy following mechanical thrombectomy for acute large vessel occlusion. A 73-year-old man was emergently brought to the authors' hospital because of left hemiparesis and consciousness disturbance. An ischemic lesion of the right cerebral hemisphere and the right internal carotid artery occlusion was revealed. Emergently, endovascular treatment was performed, and occlusion of the artery was reanalyzed. However, he suffered from hypotension with electrocardiogram abnormality. Subsequently, coronary angiography was performed, but the arteries were patent. The authors made a diagnosis of takotsubo cardiomyopathy. Endovascular recanalization for large cerebral artery occlusion is so effective that it is becoming widely used. Even in the successful recanalization, we need to care for the takotsubo cardiomyopathy.