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Case Report Open Access

Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report

  • Authors:
    • Antonia Ioana Vasile
    • Amelia Damiana Trifu
    • Cristina Nica
    • Simona Trifu
  • View Affiliations / Copyright

    Affiliations: Doctoral School, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania, Medical‑Military Institute, Carol Davila University of Medicine and Pharmacy, Bucharest 010919, Romania, Department of Neurology, University Emergency Hospital of Bucharest, Bucharest 050098, Romania, Department of Neurosciences, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
    Copyright: © Vasile et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 12
    |
    Published online on: January 11, 2026
       https://doi.org/10.3892/mi.2026.296
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Abstract

Pregnancy is considered a relative contraindication for thrombolysis. Moreover, mechanical thrombectomy should be considered for pregnant patients, as it would be indicated in non‑pregnant patients. The present study describes the clinical case of a 29‑year‑old female full‑term pregnant patient who presented to the emergency room with a sudden onset symptomatology characterized by pronunciation disorder and motor impairment in the right arm with numbness at the same level, and with a National Institutes of Health Stroke Scale score of 7 points. The patient presented in the revascularization window, and the series of acute medical interventions were as follows: Clinical examination, native head computed tomography (CT) scan, emergency cesarean section, CT angiography of the cerebral arteries, and, eventually, mechanical thrombectomy. A brain MRI revealed a hyperintense lesion in diffusion sequence with low apparent diffusion coefficient correspondence at the frontal level of the left side, affecting the middle and precentral gyrus. A transesophageal ultrasound revealed a small patent foramen ovale with a risk of paradoxical embolism score of 8 points. Usual thrombophilia laboratory test results were negative; however, a homozygous methylenetetrahydrofolate reductase gene mutation and a heterozygous positive plasminogen activator inhibitor‑1 gene mutation were detected. On the whole, the present case report emphasizes the importance of evaluating inherited genetic thrombophilia and PFO in young patients suffering a stroke. Moreover, the need for the psychological and psychiatric evaluation for possible reactive depression, anxiety and burnout in young patients suffering a stroke, and particularly in the peripartum period, is highlighted.

View Figures

Figure 1

Native head computed tomography
scan.

Figure 2

Computed tomography angiography
scan.

Figure 3

Diagram of the acute management of the
pregnant patient with acute ischemic stroke in the
revascularization window.

Figure 4

MRI findings. (A) Hyperintense lesion
in diffusion sequence at the left frontal level. (B) Low apparent
diffusion coefficient correspondence at the left frontal level. (C)
Hyperintense lesion in diffusion sequence affecting the middle
gyrus and precentral gyrus on the left side (green arrow). (D) Low
apparent diffusion coefficient correspondence at the middle gyrus
and the precentral gyrus on the left side (green arrow).
View References

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Copy and paste a formatted citation
Spandidos Publications style
Vasile AI, Trifu AD, Nica C and Trifu S: <p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>. Med Int 6: 12, 2026.
APA
Vasile, A.I., Trifu, A.D., Nica, C., & Trifu, S. (2026). <p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>. Medicine International, 6, 12. https://doi.org/10.3892/mi.2026.296
MLA
Vasile, A. I., Trifu, A. D., Nica, C., Trifu, S."<p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>". Medicine International 6.1 (2026): 12.
Chicago
Vasile, A. I., Trifu, A. D., Nica, C., Trifu, S."<p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>". Medicine International 6, no. 1 (2026): 12. https://doi.org/10.3892/mi.2026.296
Copy and paste a formatted citation
x
Spandidos Publications style
Vasile AI, Trifu AD, Nica C and Trifu S: <p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>. Med Int 6: 12, 2026.
APA
Vasile, A.I., Trifu, A.D., Nica, C., & Trifu, S. (2026). <p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>. Medicine International, 6, 12. https://doi.org/10.3892/mi.2026.296
MLA
Vasile, A. I., Trifu, A. D., Nica, C., Trifu, S."<p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>". Medicine International 6.1 (2026): 12.
Chicago
Vasile, A. I., Trifu, A. D., Nica, C., Trifu, S."<p>Therapeutic management in a pregnant patient with acute ischemic stroke in the revascularization window: A case report</p>". Medicine International 6, no. 1 (2026): 12. https://doi.org/10.3892/mi.2026.296
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