{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:01:08Z","timestamp":1771920068984,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardio-cerebral infarction (CCI) is a rare syndrome characterized by acute ischemic stroke (AIS) occurring shortly after acute myocardial infarction (AMI). Currently, there are no evidence-based guidelines for perioperative anesthesia management in patients with CCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 58-year-old male underwent coronary stent implantation for acute myocardial infarction (AMI) 4\u00a0days prior and was admitted for emergency mechanical thrombectomy due to occlusion of the right middle cerebral artery. Preoperative transthoracic echocardiography revealed left ventricular systolic dysfunction (ejection fraction &amp;lt;40%), segmental wall motion abnormalities, and a left ventricular apical thrombus, this case extends beyond simple post-myocardial infarction thromboembolism because the patient\u2019s AIS occurred in the specific context of acute, severe cardiac dysfunction (EF &amp;lt;40%) with a documented left ventricular thrombus\u2014a direct embolic source stemming from the recent AMI. This fulfills the criteria for \u201casynchronous cardio-cerebral infarction\u201d, where the brain insult is a direct consequence of the cardiac event within a short temporal window. Anesthesia was managed using a non-intubated general anesthesia approach, involving titration of sedation with sufentanil and remifentanil, combined with norepinephrine to maintain mean arterial pressure (MAP) within \u00b120% of baseline. The risk of ischemia and hemorrhage was balanced with restrictive fluid management and continuous infusion of tirofiban. Intraprocedural hemodynamics remained stable, and the procedure was successfully completed. The patient was transferred to the general ward on postoperative day three and discharged on day eleven. Troponin I and brain natriuretic peptide (BNP) levels showed a downward trend, with no evidence of heart failure, hemorrhagic transformation, or acute kidney injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this case of CCI patients, immediate echocardiography was helpful in quickly assessing cardiac function and determining the source of the thrombus. Non-invasive general anesthesia was beneficial in maintaining hemodynamic stability and airway safety. The multidisciplinary individualized anesthesia plan developed in this challenging scenario may provide practical references for perioperative management of similar high-risk CCI patients, but its general applicability still needs to be verified in larger-scale studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1711037","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T05:19:31Z","timestamp":1771910371000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful anesthesia management for middle cerebral artery thrombectomy in a patient with asynchronous cardio-cerebral infarction: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Lin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital)","place":["Qingdao, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuang","family":"Liu","sequence":"additional","affiliation":[{"name":"Operation Room, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital)","place":["Qingdao, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Wu","sequence":"additional","affiliation":[{"name":"Operation Room, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital)","place":["Qingdao, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoushi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital)","place":["Qingdao, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Song","sequence":"additional","affiliation":[{"name":"Research Management Office, Qingdao Central Hospital, University of Health and Rehabilitation Sciences","place":["Qingdao, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e017693","DOI":"10.1161\/JAHA.120.017693","article-title":"Temporal trends, predictors, and outcomes of acute ischemic stroke in acute myocardial infarction in the United States","volume":"10","author":"Aggarwal","year":"2021","journal-title":"J. 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