Two cases of posterior cerebral artery P2 occlusion with motor weakness improved by acute mechanical thrombectomy.

Abstract Background Clinical evidence to support the use of mechanical thrombectomy (MT) for posterior cerebral artery P2 occlusion (P2O) has not been established, and hemiplegia due to P2O improved by MT has not yet been reported. Two cases of P2O with hemiplegia improved by MT are reported. Case Description Case 1 was a 68-year-old man who was admitted due to right hemiplegia and dysesthesia (National Institutes of Health Stroke Scale (NIHSS) score, 14 points). Head magnetic resonance imaging (MRI) showed acute ischemia in the left inferolateral thalamus and posterior limb of the internal capsule. Angiography showed left P2O, which was recanalized after MT. Hemiplegia was improved immediately following recanalization, and the modified Rankin scale (mRS) score at discharge was 0. Case 2 was a 69-year-old man who was admitted due to left hemiplegia and dysesthesia (NIHSS score, 8 points). Head MRI showed acute ischemia in the right inferolateral thalamus and posterior limb of the internal capsule. Angiography showed right P2O, which was recanalized after MT, as in case 1. His symptoms recovered completely. Conclusions P2O may cause severe motor deficit. In such cases, MT may contribute to safely improving the patients’ deficits.