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Case Reports
. 2025 Apr 11:12:133-138.
doi: 10.2176/jns-nmc.2024-0264. eCollection 2025.

Internal Carotid Artery Occlusion Associated with Cardiac Sarcoidosis during the Postpartum Period Treated with Thrombectomy: A Case Report

Kazuhiro Touhara  1 , Takamune Achiha  1 , Shingo Toyota  1 , Shuki Okuhara  1 , Motohide Takahara  1 , Yuhei Hoshikuma  1 , Shuhei Yamada  1 , Tomoaki Murakami  1 , Maki Kobayashi  1 , Haruhiko Kishima  2
Affiliations
Case Reports

Internal Carotid Artery Occlusion Associated with Cardiac Sarcoidosis during the Postpartum Period Treated with Thrombectomy: A Case Report

Kazuhiro Touhara et al. NMC Case Rep J. .

Abstract

A 24-year-old woman, who was diagnosed with cardiac sarcoidosis as an adolescent, was brought to the emergency room with right hemiparesis and impaired consciousness 21 days after giving birth to her second child by cesarean section. Brain magnetic resonance imaging revealed high diffusion-weighted signal changes in the left insular cortex and temporal lobe. Magnetic resonance angiography revealed occlusion of the left internal carotid artery. She was treated with alteplase administration and mechanical thrombectomy, resulting in the improvement of neurological symptoms. Subsequent examination revealed a ventricular aneurysm caused by cardiac sarcoidosis, leading to the diagnosis of cardioembolic stroke. It was also assumed that the patient's postpartum period caused increased coagulability, which contributed to the ischemic stroke. It is important to recognize that abnormal cardiac function and morphology due to cardiac sarcoidosis and increased coagulability during the postpartum period may contribute to ischemic stroke.

Keywords: cardiac sarcoidosis; ischemic stroke; mechanical thrombectomy; postpartum period.

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Conflict of interest statement

All authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
MRI at onset of internal carotid artery occlusion. Diffusion-weighted MRI (A) showed acute infarction of the left frontotemporal lobe. Magnetic resonance angiography (B) showed occlusion of the left internal carotid artery. Diffusion-weighted MRI on the day after thrombectomy (C) revealed a high-signal region only on the inner side of the left temporal lobe. MRI: magnetic resonance imaging
Fig. 2
Fig. 2
Cerebral angiography during mechanical thrombectomy. The lateral view prior to thrombectomy did not show the left internal carotid artery bifurcation and beyond (A, arrow). After thrombectomy, frontal and lateral views showed complete recanalization with a Thrombolysis in Cerebral Infarction score of 3 (B, C).
Fig. 3
Fig. 3
Cardiac computed tomography angiography, coronary section, showed the presence of ventricular aneurysms on left ventricle (arrow) but no obvious thrombus.
Fig. 4
Fig. 4
Resting state FDG positron emission tomography. Abnormal FDG accumulation is seen in the apex to anterior wall, posterior septum to posterior wall, and inferior wall (arrows). FDG: fluorodeoxyglucose
See this image and copyright information in PMC

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