title: [Repeated treatment of subtotal vertebrobasilar stenosis with tissue plasminogen activator (tPA)].
abstract: We report on the successful repeated treatment of a patient with rapidly progressive severe brain-stem stroke by application of I.V. tissue plasminogen activator (tPA). This treatment twice led to a prompt remission of severe brain-stem symptoms, although a permanent therapeutic success could not be achieved. Unfortunately, the patient died a few days later from pneumonia and sepsis. Necropsy revealed bilateral partial brain-stem infarctions and a subtotal stenosis of the vertebrobasilar junction with superimposed fresh thrombus. The clinically dramatic response to tPA indicates that this type of treatment is potentially successful in high-grade subtotal basal cerebral artery stenosis with progressive stroke symptoms. In particular, application of tPA should be considered if stroke progression cannot stopped by therapeutic heprinization. A prospective randomized oligocentric study is advocated.
authors.affiliation: Abteilung Neurologie, Klinikum der RWTH Aachen.
authors.forename: I
authors.initials: I
authors.lastname: Kamps
authors.forename: J
authors.initials: J
authors.lastname: Weiss
authors.forename: E B
authors.initials: EB
authors.lastname: Ringelstein
mesh_terms: D000368:Aged; D001488:Basilar Artery / Q000473:pathology; D001933:Brain Stem / Q000098:blood supply* / Q000473:pathology; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000473:pathology / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination / Q000187:drug effects; D012008:Recurrence; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014711:Vertebral Artery / Q000473:pathology; D014715:Vertebrobasilar Insufficiency / Q000473:pathology / Q000628:therapy*
chemical_list: D010959:Tissue Plasminogen Activator
vernacular_title: Repetitive Behandlung einer subtotalen vertebrobasilären Stenose mit "tissue plasminogen activator" (tPA).