RESUMO
BACKGROUND: Arterial thrombosis is a serious and rare complication of ovarian hyperstimulation syndrome (OHSS). Herein, we describe a case of OHSS complicated by common carotid artery thrombosis and malignant middle cerebral artery infarction after egg retrieval and before embryo transfer. CASE SUMMARY: A 32-year-old female with a family history of thrombosis who was undergoing in vitro fertilization due to unexplained infertility, was admitted due to abdominal distension for 3 d and coma for 2 h. She received egg retrieval 7 d ago and embryo transfer had not yet been performed. Blood biochemical analysis showed estrogen of 15781 pmol/L. Gynecological examination showed palpable masses on both sides of the adnexal areas. Ultrasound observed enlarged ovaries and abdominal ascites. Imaging examination of the head and neck revealed fresh malignant middle cerebral artery infarction in the left side of brain and internal carotid artery as well as occlusion in the left carotid artery, internal carotid artery, and middle cerebral artery. The patient was finally diagnosed with severe OHSS, complicated by common carotid artery thrombosis and malignant middle cerebral artery infarction. Liquid replacement, anticoagulation, vascular endothelium protection, brain protection and decompressive craniectomy were carried out. Rehabilitation training was then performed for 6 mo. At present, she has poor speaking ability and decreased muscle strength on the right side. CONCLUSION: There is a risk of thrombosis during any period of OHSS. During in vitro assisted reproduction, for cases with a family history of thrombosis, hyperlipidemia and other high-risk factors, serum lipid levels should be controlled as soon as possible to improve metabolic dysfunction. When thrombosis occurs, timely and effective treatment should be performed to improve the prognosis.
RESUMO
In the present paper, the authors review the current development of studies on mechanisms of acupuncture treatment of acute ischemic cerebral apoplexy from (1) blood rheology, (2) cerebral microcirculation, 3) metabolism of cerebral tissue, (4) cerebral electrical activity, (5) free radicals and lipid peroxidation reaction, (6) excitatory aminoacid, (7) calcium overload, (8) nitrogen monoxidum, and (9) cerebral apoptosis. Cerebral stroke includes ischemic stroke and hemorrhagic stroke. Ischemic cerebral stroke accounted for about 60%-70% of all the stroke cases. At present, the main remedies for treating acute ischemic cerebral stroke includes thrombolysis, anti-platelet aggregation, improving microcirculation and symptomatic therapy. In stroke, highlighting the efficacy of acupuncture therapy in the treatment of stroke.
