Anticipándonos al desastre: trombectomía mecánica en paciente con NIHSS bajo

The effectiveness of endovascular treatment for acute stroke is well established. International treatment guidelines recommend endovascular treatment for patients with proximal intracranial artery occlusions and NIHSS scores ≥ 6. However, patients with proximal occlusions may initially score low on the NIHSS before the collapse of compensatory mechanisms and the onset of the severe symptoms usually associated with large-vessel occlusions. We present the case of a patient arriving at the emergency department with ischaemic stroke, scoring 1 on the NIHSS. She had a thrombus in the terminal segment of the right internal carotid artery (ICA) and extending up to the M1 segment of the middle cerebral artery (MCA), which was extracted by mechanical thrombectomy.