Mr. Van, 72, recently recovered from a stroke at Tam Anh General Hospital Ho Chi Minh City after doctors removed a 9 cm blood clot from his brain. He was discharged after just 5 days, regaining almost full muscle strength and improved speech.

The emergency intervention was necessary after Mr. Van experienced sudden weakness on one side of his body upon waking, followed by slurred speech, confusion, impaired consciousness, drowsiness, and his right eye deviated. A CT scan revealed acute temporal lobe cerebral infarction due to a middle cerebral artery blockage caused by a thrombus (blood clot).

Doctor Duong Dinh Hoan, Head of the Neurointervention Unit, Center for Diagnostic Imaging and Interventional Radiology, explained that the middle cerebral artery is vital, supplying most of the cerebral hemisphere. Its blockage can lead to coma, paralysis on one side, and speech loss without prompt emergency revascularization. In large vessel occlusion strokes, millions of brain cells die permanently each minute.

Upon admission, Mr. Van's ischemic brain region already showed damage. As the stroke occurred during sleep, the exact onset time could not be determined. Extensive cerebral infarction seen on the CT scan meant thrombolytic drugs were unsuitable due to a high risk of complications. The medical team opted for endovascular thrombectomy to restore blood flow to the brain.

In the digital subtraction angiography (DSA) room, doctors inserted a catheter through the femoral artery to reach the brain blockage. Angiography confirmed complete occlusion of the M1 segment of the middle cerebral artery.

One of Mr. Van's large cerebral arteries was completely blocked before intervention (left) and was fully revascularized, restoring blood flow to the brain (right). Photo: Tam Anh General Hospital

The team used a combined thrombectomy and stenting technique, known as the Solumbra strategy, one of the modern interventional techniques for large vessel occlusion strokes. Doctors used an aspiration catheter combined with a retrievable stent to extract the entire blood clot, restoring blood flow to the brain in the shortest possible time. The primary goal was to save brain parenchyma not yet infarcted.

After two hours, doctors successfully removed a 9 cm long black thrombus from Mr. Van's right middle cerebral artery. A post-procedure scan confirmed complete revascularization of the cerebral artery.

Following the procedure, the patient was alert, responsive, with improved speech and movement, and almost full muscle strength recovery. He was discharged after 5 days.

Recognizing stroke signs like facial drooping, arm or leg weakness, and speech difficulties is crucial. When any signs appear, call emergency services immediately and transport the patient to a facility with a specialized stroke unit as soon as possible. Timely stroke intervention during the "golden window" significantly impacts recovery. Patients receiving delayed intervention face a high risk of weakness, paralysis, disability, or death.

Nhu Ngoc

*Patient's name has been changed