Cholesterol Crystals in the Retrieved Thrombus by Mechanical Thrombectomy for Cerebral Embolism: A Case Report and Literature Review

• DOI: 10.2176/jns-nmc.2022-0095
• Publication Date: 2022-07-26T22:10:34Z
• Authors: Natsuki SUGIYAMA; Hiroshi HASEGAWA; Kentaro KUDO; Ryo MIYAHARA; Rikizo SAITO; Chikashi MARUKI; Masaru TAKASE; Akihide KONDO; Hidenori OISHI
• Keywords: Stroke; Atheroma

There are only a few case reports in which cholesterol crystals were found the thrombus retrieved by mechanical thrombectomy for cryptogenic stroke, leading to definitive diagnosis. We herein report of aortogenic embolic stroke diagnosed presence rich and review previously reported cases. A woman her 80s was transferred as an emergency due consciousness disturbance, right conjugate deviation, severe left hemiparesis. Magnetic resonance imaging showed occlusion middle cerebral artery (MCA) acute infarction territory. The MCA recanalized using aspiration catheter stent retriever, symptoms improved. Although physiological examination did not detect source during hospitalization, pathological revealed atheroma with numerous crystal clefts intermixing fibrin. Contrast-enhanced computed tomography performed based on results atheromatous lesions aortic arch source. As subsequent treatment, medications strong statin antiplatelet agent continued, patient had no recurrence. finding that is simple containing poor hemocytes suggests embolism plaque rupture. Pathological obtained one useful diagnostic approaches etiology determination its treatment.