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• Vol.58 No.5
• CLINICA NEUROL, 58: 314−319, 2018
• Vol.58 No.5 contents

Case Report

Embolic stroke immediately after initial administration of intravitreal aflibercept

Hironori Mizutani, M.D.¹⁾²⁾, Yuichiro Inatomi, M.D.¹⁾, Takaomi Singu, M.D.¹⁾, Makoto Nakajima, M.D.²⁾, Toshiro Yonehara, M.D.¹⁾ and Yukio Ando, M.D.²⁾

¹⁾Department of Neurology, Saiseikai Kumamoto Hospital
²⁾Department of Neurology, Graduate School of Medical Sciences, Kumamoto University

A 72-year-old man was admitted to our hospital because of right upper limb monoplegia 8 hours after the initial intravitreal injection of aflibercept, which is an inhibitor of vascular endothelial growth factor. Magnetic resonance diffusion-weighted images showed recent ischemic lesions in the left corona radiata and the right superior frontal gyrus. Laboratory findings showed mild hyperfibrinolysis. A patent foramen ovale was diagnosed on transesophageal echocardiography; however, lower-extremity ultrasonography did not detect deep vein thrombosis. The source of embolism remained unknown. A possible mechanism of cerebral emboli in the present case was a rapidly induced hypercoagulative state due to transfer of aflibercept from the vitreous body to the systemic circulation.
Full Text of this Article in Japanese PDF (441K)

(CLINICA NEUROL, 58: 314−319, 2018)
key words: anti-vascular endothelial growth factor therapy, brain embolism, age-related macular degeneration, intravitreal injection, hypercoagulative state

(Received: 27-Feb-18)