Brain Embolism caused by Acute Middle Cerebral Artery Occlusion after Left Upper Lobectomy for Lung Cancer : Case Report and Review of Literature

Here, we present a case of acute middle cerebral artery （ MCA ） embolic occlusion caused by thrombus from the left superior pulmonary vein after lung lobectomy. A 72 ‒ year ‒ old woman presenting with right hemiparesis and aphasia six days after left upper lobectomy for lung cancer was transferred to our hospi-tal. Magnetic resonance imaging showed MCA occlusion and acute large cerebral infarction. The thrombus in the stump of the left superior pulmonary vein was detected by contrast ‒ enhanced chest computed tomography. She was treated with rivaroxaban, and her pulmonary vein thrombus dissolved. Based on previous reports, left upper lobectomy is a risk factor for pulmonary vein thrombus and embolic brain infarction. In our opinion, we neurosurgeons need to understand that pulmonary thrombus may cause large vessel occlusion after lung surgery.