Recombinant tissue plasminogen activator in two patients with basilar artery occlusion.
Two patients with angiographically proved basilar artery occlusion were treated with systemic recombinant tissue plasminogen activator (rtPA) according to protocol. The first patient was in a locked-in state and gradually deteriorated. On repeat angiography the basilar artery remained occluded. He died and necropsy revealed a pontine haemorrhagic infarction. The second patient, who was comatose and with decerebrate posturing, made a remarkable recovery. Angiography showed reperfusion. Therapy was initiated in the first patient after six hours and in the second after two hours. Treatment with rtPA is promising but probably not feasible for every patient. Success may depend on duration of occlusion and composition of occluding thrombus.
Herderscheê
D
D
Academisch Medisch Centrum, Amsterdam, The Netherlands.
Limburg
M
M
Hijdra
A
A
Koster
P A
PA
D000328:Adult; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D001933:Brain Stem / Q000098:blood supply*; D002533:Cerebral Angiography; D005500:Follow-Up Studies; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D013382:Subtraction Technique; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator