Successful MCA Stenting for TIA in a 46-Year-Old Patient: A Case Study
A 46-year-old gentleman from North Karnataka presented with complaints of left-sided weakness and difficulty speaking for 10 days prior to his arrival at 1224, G-Floor, 26th Main, 9th block, Jayanagar, Opp to Ragiguddada Anjaneyaswamy Temple Arch, Bangalore, Karnataka 560069. On examination, he was conscious, alert, and oriented, with no noticeable motor or sensory deficits. Further investigation led to a diagnosis of a Transient Ischemic Attack (TIA), a condition often referred to as a mini-stroke. Here’s an in-depth look into his diagnosis, treatment, and recovery process.
Initial Diagnosis
The patient underwent an MRI brain stroke protocol, which revealed watershed infarcts in the right middle cerebral artery (MCA) territory with high-grade stenosis of the MCA. To further evaluate the extent of the problem, a Digital Subtraction Angiogram (DSA) was performed, showing more than 95% focal stenosis, with significantly reduced blood flow into the distal branches of the M2 and M3 segments of the MCA.
This high-grade stenosis posed a significant risk of a major stroke, prompting the team to plan for MCA stenting after carefully explaining the benefits and risks to the patient.
What is MCA Stenting?
The Middle Cerebral Artery (MCA) is one of the major blood vessels supplying the brain. Stenting is a minimally invasive procedure that involves placing a small tube called a stent inside the narrowed artery to restore proper blood flow.
Unlike traditional brain surgery, MCA stenting doesn’t require opening the skull (craniotomy). Instead, thin wires and catheters, as small as a strand of hair, are inserted through a blood vessel in the thigh. These wires are guided all the way to the narrowed brain artery, where the stent is placed to open up the blocked area.
Procedure Overview
The patient was taken to the catheterization (Cath) lab for the procedure. A right femoral puncture was made to insert the guide wires and a micro-catheter. Using these tools, the team successfully reached the right MCA and placed a 2.25mm x 8mm stent in the brain vessel. The patient tolerated the procedure well, with no complications during or after the stenting.
Post-Operative Results and Recovery
A post-operative CT scan showed no signs of bleeding or stroke. The patient experienced no complications and was able to walk the next day. He was discharged two days later, in good condition.
Understanding Transient Ischemic Attacks (TIA)
A Transient Ischemic Attack (TIA), also called a mini-stroke, is a temporary blockage of blood flow to the brain. Unlike a major stroke, the symptoms of a TIA usually resolve within 24 hours. However, it is crucial to identify the underlying cause, as a TIA is often a warning sign of a more serious stroke.
Symptoms of TIA
ㆍWeakness in the face or limbs, typically on one side
ㆍDifficulty speaking or understanding speech
ㆍDizziness or loss of balance
ㆍTemporary vision disturbances
ㆍNumbness or tingling sensations
Diagnosing TIA
A variety of diagnostic tools are used to confirm a TIA and identify the cause:
ㆍDuplex scan
ㆍCT scan of the brain
ㆍMRI of the brain
ㆍMRA angiogram
ㆍEchocardiogram (ECHO)
ㆍPerfusion brain scan
ㆍDSA (Digital Subtraction Angiogram)
Importance of Early Detection and Treatment
TIAs are a critical warning sign, predicting a higher risk of a major stroke. Studies show that about 15% of people who experience a TIA will suffer a major stroke within three months. The risk increases to 30-40% within one year if left untreated. Therefore, prompt diagnosis and treatment are essential to prevent a future stroke.
Preventive Treatments for Stroke
Several interventional procedures are available to prevent strokes in high-risk individuals, such as those who have experienced a TIA:
ㆍMCA Stenting: This is the procedure that was performed in this case to treat severe stenosis and restore blood flow to the brain.
ㆍCarotid Artery Stenting: This procedure is used to treat blockages in the carotid arteries in the neck, which supply blood to the brain.
ㆍMechanical Thrombectomy: This is an emergency treatment used to remove large blood clots during an acute stroke.
These minimally invasive procedures can dramatically reduce the risk of a major stroke, especially in patients with a history of TIA.
Conclusion
In this case, the timely diagnosis of MCA stenosis and the successful MCA stenting procedure helped prevent a major stroke for the 46-year-old patient. With the growing availability of advanced interventional treatments, it is possible to reduce the risk of life-threatening strokes in patients with conditions like TIA.
For those at risk, early medical intervention can make all the difference in ensuring a full recovery. If you experience symptoms of a mini-stroke, it’s essential to seek medical attention promptly.
This surgery was performed, Consultant Neurosurgeon specializing in brain and spine surgery.
Advanced MCA Stenting in Bangalore
“Minimally invasive pin-hole brain surgery can save lives after stroke. Consult Dr. Ganesh Veerabhadraiah at Neurowellness today.”
FAQs
1. What is MCA stenting?
MCA stenting is a minimally invasive brain procedure to open narrowed arteries and restore blood flow after a stroke.
2. Is MCA stenting safe?
Yes, when performed by skilled neurosurgeons, MCA stenting is a safe and effective way to prevent further strokes.
3. How long is recovery after MCA stenting?
Most patients recover within a few days in the hospital and can resume normal activities within weeks.
4. Who needs MCA stenting?
Patients with blocked middle cerebral arteries at high risk of stroke are recommended for MCA stenting.
5. Where can I get MCA stenting in Bangalore?
Neurowellness Brain & Spine Clinic offers advanced MCA stenting with minimally invasive techniques.
About Author
Dr. Ganesh Veerabhadraiah
Dr. Ganesh Veerabhadraiah, leading neurosurgeon and neurologist in Bangalore, has over 20 years of expertise in managing back pain, migraines, headaches, neuro disorders, and spine problems. His clinical excellence and patient-first approach make him one of the most trusted neuro doctors in Bangalore.
At Neurowellness Brain & Spine Clinic in Jayanagar and Kavery Hospital Electronic City, Dr. Ganesh provides comprehensive treatments ranging from minimally invasive spine surgery to advanced neurological care. As a respected back pain specialist and migraine doctor, he continues to deliver reliable outcomes for patients.
👉 Connect with Dr. Ganesh on LinkedIn
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