title: [Intravenous thrombolytic therapy: ideal treatment for acute ischemic stroke].
abstract: In four patients with symptoms of presumed acute ischaemic stroke intravenous treatment with recombinant tissue plasminogen activator (rtPA) was considered. Two patients indeed received rtPA within 3 hours after onset of symptoms. One of them, a 55-year-old woman, recovered and was able to resume her job as a teacher four months later. The other patient, a 38-year-old man, had a severe bleeding complication that could be stopped, but the patient died several days later because of the massive stroke. The third patient, an 82-year-old woman, could not be treated with rtPA because the time of onset of neurological deficit was uncertain. Nevertheless, she recovered well from her hemiplegia after a few days. The fourth patient, a 24-year-old woman, did not receive rtPA because her symptoms were thought to be the result of a psychogenic disorder. Intravenous thrombolysis increases the risk of intracranial haemorrhage, but should be considered a useful treatment for ischaemic stroke provided there is no doubt about this diagnosis and treatment with rtPA can be started within 3 hours of onset of the neurological deficit.
authors.affiliation: Afd. Neurologie, Universitair Medisch Centrum Utrecht.
authors.forename: L J
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: H B
authors.initials: HB
authors.lastname: van der Worp
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000139:chemically induced*; D002543:Cerebral Hemorrhage / Q000139:chemically induced*; D002544:Cerebral Infarction / Q000188:drug therapy* / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000009:adverse effects / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator
vernacular_title: Intraveneuze trombolyse: de ideale oplossing voor het herseninfarct?