Thrombolysis beyond the guidelines: two treatments in one subject within 90 hours based on a modified magnetic resonance imaging brain clock concept.
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.
Topakian
Raffi
R
Department of Neurology, Hospital Wagner-Jauregg Linz, Austria. raffi.topakian@aon.at
Gruber
Franz
F
Fellner
Franz A
FA
Haring
Hans-Peter
HP
Aichner
Franz T
FT
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