title: Tissue plasminogen activator thrombolysis of a middle cerebral artery embolus in a patient with an arteriovenous malformation. Case report.
abstract: A patient harboring a cerebral arteriovenous malformation (AVM) underwent angiography in an attempt to embolize the AVM. During catheterization (and prior to embolization) he became hemiplegic and aphasic. Angiography revealed a complete middle cerebral artery (MCA) occlusion by an embolus. The patient was treated with recombinant tissue plasminogen activator (t-PA), a thrombolytic agent. Restoration of MCA flow was achieved, and the patient recovered. Immediately after MCA embolus, t-PA infusion may lead to thrombolysis and neurological recovery. The decision-making process as well as the risks associated with the use of t-PA are discussed.
authors.affiliation: Department of Neurosurgery, New York University Medical Center, New York.
authors.forename: J J
authors.initials: JJ
authors.lastname: Jafar
authors.forename: W S
authors.initials: WS
authors.lastname: Tan
authors.forename: R M
authors.initials: RM
authors.lastname: Crowell
mesh_terms: D000328:Adult; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging; D002542:Intracranial Embolism and Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D011859:Radiography; D011994:Recombinant Proteins / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator