Document Detail

Thrombolytic therapy in vertebrobasilar occlusion.
MedLine Citation:
PMID:  1343857     Owner:  NLM     Status:  MEDLINE    
Since 1983 at the Alfred Hospital 4 patients with thrombotic or embolic vertebrobasilar occlusions have been treated with intra-arterial streptokinase (SK) infusions for the effects of persisting brainstem ischaemia despite anticoagulation with heparin. In 3 cases there was immediate and dramatic neurological improvement, in all cases associated with arteriographically demonstrated reperfusion of a blocked vessel. Two of these patients suffered further thromboembolic vertebral or basilar artery occlusions (3 days and 2 years later) but recovered fully without further thrombolytic therapy. The other patient was given intra-arterial SK 12 days after an apparently completed brainstem stroke: the therapy failed to cause reperfusion of a vertebral occlusion or produce any clinical improvement. Complications from the therapy were nausea requiring the termination of the SK infusion in one case, easily controlled bleeding from a recent surgical wound, and a clinically insignificant haemorrhagic transformation of cerebellar infarction in a third. The benefits of thrombolytic therapy in vertebrobasilar ischaemia and the dose of streptokinase required are discussed.
D Thyagarajan; R J Stark; J Frayne; B S Gilligan; N Sacharias
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical and experimental neurology     Volume:  29     ISSN:  0196-6383     ISO Abbreviation:  Clin Exp Neurol     Publication Date:  1992  
Date Detail:
Created Date:  1994-03-31     Completed Date:  1994-03-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7909724     Medline TA:  Clin Exp Neurol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  129-42     Citation Subset:  IM    
Department of Neurology, Alfred Hospital, Melbourne.
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MeSH Terms
Cerebral Angiography
Injections, Intra-Arterial
Middle Aged
Streptokinase / therapeutic use
Thrombolytic Therapy* / adverse effects
Tomography, X-Ray Computed
Vertebrobasilar Insufficiency / radiography,  therapy*
Reg. No./Substance:
EC 3.4.-/Streptokinase

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