Reactions 1704, p309 - 2 Jun 2018
Acute ischemic stroke: case report
A 68-year-old woman developed acute ischaemic stroke
following administration of polidocanol [dosage not stated].
The woman suddenly developed hemiplegia and numbness
in her right arm 30 minutes after foam sclerotherapy. Prior to
the event, she had received seven polidocanol foam injections
into the varicose veins of her right leg. At the time of admission
to the hospital, mild weakness in her right hand remained
grasping 9kg and pinching 2kg. Her national institutes of
health stroke scale (NIHSS) score was 3. Laboratory
investigation revealed elevated D-dimer value (9.3 g/mL), but
normal number of platelets and blood sugar value. She was
diagnosed with acute ischaemic stroke.
In response to this, she received treatment with IV
recombinant tissue-type plasminogen activator (rt-PA)
following 89 minutes of stroke onset. Venous ultrasonography
of the lower extremities revealed venous thrombosis in her
right soleus vein. Transesophageal echocardiography with the
valsalva contrast test revealed a patent foramen ovale. The
venous thrombosis did not change after rt-PA therapy. Right
hand weakness gradually improved to grasp 30kg and to pinch
8kg, and she was discharged 13 days following the onset, with
a modified rankin scale of 1, which was same as admission.
Author comment: "Some ischemic stroke cases after foam
sclerotherapy to the varicose veins were recently reported in
patients with patent foramen ovale."
Matsuzono K, et al. Tissue Plasminogen Activator to Treat a Stroke after Foam
Sclerotherapy in a Woman with a Patent Foramen Ovale. Journal of Stroke and
Cerebrovascular Diseases 27: e110-e112, No. 6, Jun 2018. Available from: URL:
http://doi.org/10.1016/j.jstrokecerebrovasdis.2018.01.001 - Japan
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved