Recrudescence of symptoms of remote ischemic stroke after a cerebral angiogram: Report of a case.

Recrudescence of symptoms of remote ischemic stroke after a cerebral angiogram: Report of a case.

World Neurosurg. 2017 Mar 08;:

Authors: Falatko SR, Schmalz PG, Harrigan M

Abstract
BACKGROUND: Recrudescence, or reappearance of previously resolved symptoms of ischemic stroke, may occur after physiological stress. Although this syndrome is generally thought to be uncommon, it may actually account for a significant proportion of stroke mimics.
CASE DESCRIPTION: A 67-year-old man was admitted with a Hunt-Hess grade II spontaneous subarachnoid hemorrhage. He underwent a digital subtraction cerebral angiogram as part of his imaging evaluation. About 30 minutes after the procedure, he developed dysarthria, right facial droop and a right pronator drift. The patient and family denied a history of similar symptoms or previous ischemic stroke. A brain MRI demonstrated a remote left lacunar infarction. The patient's symptoms resolved after 24 hours and were attributed to recrudescence of his previous lacunar infarction. It is likely that the physiological stress of the subarachnoid hemorrhage, combined with the cerebral angiogram, triggered the event.
CONCLUSION: Recrudescence of symptoms due to a previous stroke may be initiated by subarachnoid hemorrhage and/or a cerebral angiogram. The possibility of ischemic stroke recrudescence should be kept in mind as a possible stroke mimic.

PMID: 28284968 [PubMed - as supplied by publisher]

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