Document Detail

Reversal of locked-in syndrome with anticoagulation, induced hypertension, and intravenous t-PA.
MedLine Citation:
PMID:  16159079     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Widespread use of intravenous tissue plasminogen activator (t-PA) for acute ischemic stroke is limited by multiple contraindications to its use. CASE REPORT: This article describes a patient with stuttering symptoms of pontine ischemia caused by vertebrobasilar dissection who suddenly deteriorated into a locked-in state 32 hours after symptom onset. The quadriparesis was successfully reversed within 3 hours of onset with the combination of pharmacologically induced hypertension, anticoagulation, and intravenous t-PA. DISCUSSION: Even in the face of numerous contraindications (including hypertension, anticoagulation, and treatment beyond 3 hours of symptom onset), intravenous t-PA can be used successfully in carefully selected cases.
Nazli Janjua; Katja E Wartenberg; Philip M Meyers; Stephan A Mayer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurocritical care     Volume:  2     ISSN:  1541-6933     ISO Abbreviation:  Neurocrit Care     Publication Date:  2005  
Date Detail:
Created Date:  2005-09-14     Completed Date:  2005-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  296-9     Citation Subset:  IM    
The Neurological Intensive Care Unit, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
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MeSH Terms
Anticoagulants / therapeutic use
Drug Administration Schedule
Infusions, Intravenous
Plasminogen Activators / administration & dosage*
Quadriplegia / drug therapy*,  etiology
Tissue Plasminogen Activator / administration & dosage*
Vasoconstrictor Agents / therapeutic use
Vertebral Artery Dissection / complications
Reg. No./Substance:
0/Anticoagulants; 0/Vasoconstrictor Agents; EC 3.4.21.-/Plasminogen Activators; EC Plasminogen Activator

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