Late intra-arterial thrombolysis.
A 70-year-old woman with a progressive dominant hemisphere syndrome but only mild hemiparesis and a normal brain scan (>3 hours from stroke onset) showed angiographic occlusion of the left anterior cerebral artery and the middle cerebral artery at its trifurcation with preservation of the rolandic artery. Intra-arterial thrombolysis was started >6 hours from onset of symptoms. Recanalization occurred and the patient recovered with a transcortical motor aphasia and no motor deficit. A negative brain scan and an incomplete large hemispheric syndrome may indicate an extended time-window for intra-arterial thrombolysis.
Stapf
C
C
Stroke Center/The Neurological Institute, Columbia University College of Physicians & Surgeons, New York, NY, USA. cs585@columbia.edu
Marshall
R S
RS
Mohr
J P
JP
Duong
H D
HD
Brunson
J C
JC
Benson
R T
RT
Mast
H
H
D000368:Aged; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008279:Magnetic Resonance Imaging; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*