A 52-year-old man with dilated cardiomyopathy and atrial fibrillation developed right CRAO and, nine days later, a hemispheric ischemic stroke from right ICA occlusion that was treated with mechanical thrombectomy, and CRAO warrants prompt cerebrovascular and cardiac evaluation with reassessment when new neurological deficits develop.
A patient with sudden painless right-eye vision loss, supported as right CRAO, later developed a hemispheric ischemic stroke nine days afterward.
The patient had cardiac conditions that are potential embolic sources.
Imaging at neurological presentation showed right ICA occlusion from its origin with a large penumbra relative to the infarct core.
Mechanical thrombectomy with aspiration and adjunctive balloon angioplasty achieved near-complete reperfusion.
The patient had a good neurological outcome, but right-eye vision loss persisted.
CRAO should prompt rapid cerebrovascular and cardiac evaluation, with reassessment if new neurological deficits develop.
The authors caution that the nine-day interval does not establish how long the carotid was occluded or the brain was ischemic.
The favorable outcome in this single patient does not establish the efficacy of thrombectomy beyond 24 hours.
This case report describes a 52-year-old man who suddenly lost vision in his right eye without pain. The eye doctors diagnosed a blockage of the main artery supplying the retina (central retinal artery occlusion, or CRAO), which is a type of stroke. Nine days later he developed left-sided weakness and trouble speaking. He had a known weak heart muscle (dilated cardiomyopathy), and a heart tracing showed atrial fibrillation, an irregular rhythm that can cause clots. Scans showed that his right internal carotid artery, a major artery to the brain, was blocked. Brain perfusion imaging suggested a large area of brain that was at risk but still potentially salvageable. Doctors removed the clot using a catheter-based procedure (mechanical thrombectomy) and opened the artery with a balloon, restoring nearly complete blood flow. His stroke severity score improved from 8 to 2 by discharge, and at 3 months he had only minimal disability. His right-eye vision loss did not recover. This research suggests that an eye stroke may be a warning sign of heart or brain-artery problems and may merit prompt evaluation of both, and repeat assessment if new neurological symptoms appear. The authors stress limits: this is a single patient, the nine-day gap does not show how long the artery or brain was affected, and the good result does not prove that thrombectomy works when performed more than 24 hours after symptoms start.
Wen X, Guo B, Zeng X, Xiang Z, Deng Z, Yuan Z. (2026). Central retinal artery occlusion preceding hemispheric ischemic stroke treated with mechanical thrombectomy: A case report.. Medicine. https://doi.org/10.1097/MD.0000000000051229