Acute ischemic stroke in a third trimester of pregnancy - cesarean section followed by mechanical thrombectomy

Background: Acute ischemic stroke (AIS) in pregnancy, despite being a rare event, poses a serious risk for mother's and child's health. There are no strict treatment guidelines in this group of patients, with safety and efficacy of intravenous recombinant tissue-plasminogen-activator (rtPA) and mechanical thrombectomy (MT) being uncertain. Case Presentation: We present a case of gravid 27-year-old patient with left middle cerebral artery (MCA) proximal occlusion causing AIS that was successfully treated with MT. Being in 35(th) gestational week, it was decided to perform caesarean section before endovascular treatment. The outcome of treatment was good, with no mother's neurological deficit and proper child development in the 5-year observation. Conclusions: MT is probably safe and efficient treatment method in selected pregnant women. No harmful effects on further pregnancy course and parturition have been observed to date.