Middle Cerebral Artery Ischemic Stroke Occurring in a Woman With Metastatic Breast Cancer: A Case Report

TL;DR

A woman with metastatic breast cancer experienced an ischemic stroke in the middle cerebral artery and was successfully treated with mechanical thrombectomy.

Contribution

This case report presents a rare instance of MCA stroke in a metastatic breast cancer patient and emphasizes the need for a multidisciplinary approach.

Findings

A 42-year-old woman with metastatic breast cancer had an acute infarction in the right MCA.

Mechanical thrombectomy successfully achieved complete recanalization.

Aspirin monotherapy was initiated to prevent stroke recurrence.

Abstract

Brain metastasis refers to the spread of cancer cells from a primary tumor to the brain. A rare but serious complication of brain metastasis is middle cerebral artery (MCA) occlusion. This report discusses a case involving a 42-year-old woman with metastatic breast cancer who presented to the emergency department with symptoms of weakness, headache, mouth deviation, and dysarthria that had lasted for two hours. Prior to this incident, she had been in her usual state of health. Upon physical examination, it was noted that the patient had left-sided hemiparesis. A brain CT scan with contrast showed no changes compared to her baseline imaging. However, a stroke protocol CT angiogram and brain perfusion scan indicated an acute infarction in the right MCA. To treat her condition, complete recanalization was achieved successfully through mechanical thrombectomy. Following the procedure, a post-mechanical thrombectomy protocol was established, and the patient was admitted to the ICU. To reduce the risk of stroke recurrence, aspirin monotherapy was initiated. This case highlights the importance of a multidisciplinary approach when managing ischemic stroke in patients with metastatic cancer.

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