title: Thrombolysis beyond the guidelines: two treatments in one subject within 90 hours based on a modified magnetic resonance imaging brain clock concept.
abstract: OBJECTIVE
  We report the first case of 2 intravenous thrombolysis treatments within 90 hours in a patient with early recurrent stroke.
  
  
  RESULTS
  A 50-year-old man had improved significantly after intravenous thrombolysis for acute stroke. On the fourth day, he deteriorated dramatically because of recurrent stroke. Evidence of vessel reocclusion and profound perfusion/diffusion mismatch constituted the rationale for a second thrombolysis treatment, which resulted in vessel recanalization and significant neurologic improvement.
  
  
  CONCLUSIONS
  The pathophysiological information obtained by multimodal magnetic resonance imaging may suit as a brain clock when repeat thrombolysis treatment is considered for early recurrent stroke.
authors.affiliation: Department of Neurology, Hospital Wagner-Jauregg Linz, Austria. raffi.topakian@aon.at
authors.forename: Raffi
authors.initials: R
authors.lastname: Topakian
authors.forename: Franz
authors.initials: F
authors.lastname: Gruber
authors.forename: Franz A
authors.initials: FA
authors.lastname: Fellner
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Haring
authors.forename: Franz T
authors.initials: FT
authors.lastname: Aichner
mesh_terms: D001921:Brain / Q000473:pathology*; D002545:Brain Ischemia / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology; D012008:Recurrence; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors