| Basilar artery occlusion in a child: "clot angioplasty" followed by thrombolysis. | |
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MedLine Citation:
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PMID: 11007500 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Basilar artery occlusions are rare but have a very poor prognosis. Intra-arterial thrombolysis may produce recanalization and better clinical outcome. A short delay between the onset of symptoms and thrombolysis is considered essential for successful recanalization and for the smallest possible risk of haemorrhagic complications. We present a case of basilar artery occlusion in an 8-year-old child, which was treated by "clot angioplasty" followed by intra-arterial thrombolysis. Thirty hours after progressive alteration of consciousness, speech disturbances and left arm paresis, the child became comatose with decerebrate rigidity. A CT scan showed parenchymal ischaemic lesions. Angiography (performed 36 h after the onset of symptoms) showed a total occlusion of the basilar artery. A clot angioplasty was performed by placing a balloon catheter within the thrombus and inflating it several times in the occluded segment of the basilar artery. Thrombolysis was then performed through the balloon catheter. The basilar artery was only partially recanalized at the end of the procedure, but the perforating arteries of the brain stem had reappeared on angiography. Three months later the child had completely recovered to a normal clinical status. In conclusion, the very poor natural prognosis of basilar artery occlusion requires aggressive management. Recanalization of the basilar artery may be performed even late after the onset of symptoms. Clot angioplasty allows partial recanalization, which may increase the efficiency of thrombolysis. |
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Authors:
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C Cognard; A Weill; S Lindgren; M Piotin; L Castaings; J Moret |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: 16 ISSN: 0256-7040 ISO Abbreviation: Childs Nerv Syst Publication Date: 2000 Aug |
Date Detail:
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Created Date: 2001-02-02 Completed Date: 2001-02-02 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: GERMANY |
Other Details:
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Languages: eng Pagination: 496-500 Citation Subset: IM |
Affiliation:
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Service de Neuroradiologie, Hôpital Purpan, Toulouse, France. c@chu-toulouse.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Angioplasty, Balloon / methods* Arterial Occlusive Diseases / diagnosis*, drug therapy* Basilar Artery* / pathology, radiography Cerebral Angiography Child Humans Magnetic Resonance Imaging Male Plasminogen Activators / therapeutic use* Thrombolytic Therapy / methods* Tomography, X-Ray Computed Urokinase-Type Plasminogen Activator / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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EC 3.4.21.-/Plasminogen Activators; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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