Document Detail


Right internal carotid artery occlusion during intravenous thrombolysis for left middle cerebral artery occlusion.
MedLine Citation:
PMID:  19110150     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombolysis with recombinant tissue plasminogen activator is the only established treatment for acute ischemic stroke. Recurrent ischemic stroke involving an initially unaffected arterial territory during the course of thrombolysis has been reported but remains exceptionally rare. Here we report a 75-year-old woman with acute left middle cerebral artery occlusion who developed right internal carotid artery occlusion during the last minutes of recombinant tissue plasminogen activator infusion. Although the transthoracic echocardiography did not reveal an intra-atrial thrombus, cardioembolism due to disintegration of a pre-existing thrombus was thought to be the underlying mechanism because the patient had atrial fibrillation. Arterial occlusion due to intraplaque hemorrhage and de novo thrombosis caused by thrombin-mediated platelet aggregation are also discussed as potential mechanisms of arterial occlusion.
Authors:
Gul Yalcin-Cakmakli; Erhan Akpinar; Mehmet Akif Topcuoglu; Turgay Dalkara
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  18     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-26     Completed Date:  2009-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  74-7     Citation Subset:  IM    
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Neurology, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Artery, Internal* / pathology
Carotid Stenosis / chemically induced,  etiology*,  pathology
Cerebral Angiography
Diffusion Magnetic Resonance Imaging
Embolism / complications
Female
Fibrinolytic Agents / administration & dosage,  adverse effects*
Heart Diseases / complications
Humans
Infarction, Middle Cerebral Artery / drug therapy*,  pathology
Infusions, Intravenous
Recombinant Proteins / administration & dosage
Risk Factors
Thrombolytic Therapy*
Tissue Plasminogen Activator / administration & dosage,  adverse effects*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Recombinant Proteins; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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