Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8602
Peer-review started: May 25, 2021
First decision: June 24, 2021
Revised: July 8, 2021
Accepted: August 12, 2021
Article in press: August 12, 2021
Published online: October 6, 2021
Cerebral infarction is an extremely rare postoperative complication of anterior cervical discectomy and fusion (ACDF), particularly in the delayed setting. We present a case who had a sudden stroke on day 18 after surgery. By sharing our experience with this case, we hope to provide new information about stroke after anterior cervical surgery.
We present the case of a 61-year-old man with more than 20 years of hypertension and 14 years of coronary heart disease who had suffered a stroke 11 years ago. The patient was admitted for a multiple ACDF due to symptoms of cervical spondylotic myelopathy and had a sudden stroke on day 18 after surgery. Imaging findings showed a large-area infarct of his left cerebral hemisphere and thrombosis in his left common carotid artery. With the consent of his family, the thrombus was removed and a vascular stent was implanted through an interventional operation. Forty days later, the patient was transferred to a rehabilitation hospital for further treatment. He had normal consciousness but slurred speech at the 1-year follow-up evaluation. The motor and sensory functions of his hemiplegic limbs partially recovered.
This case illustrated that a postoperative stroke related to anterior cervical surgery may be attributed to prolonged carotid retraction and might have a long silent period. Preventive measures include careful preoperative and postoperative examination for high-risk patients as well as gentle and intermittent retraction of carotid artery sheath during operation.
Core Tip: A postoperative stroke related to anterior cervical surgery is rare and may have a long silent period during which a carotid thrombus had formed at the surgical site. Preventive measures include gentle and intermittent retraction of carotid artery sheath during surgery, careful preoperative risk assessment and grading, and con