Document Detail


Use of intravenous tissue plasminogen activator in a 16-year-old patient with basilar occlusion.
MedLine Citation:
PMID:  18827269     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intravenous tissue plasminogen activator (t-PA) is currently approved by the US Food and Drug Administration (FDA) for the treatment of ischemic stroke in patients > 18 years of age who present within 3 hours of stroke onset and meet certain criteria. We report a case of a 16-year-old, previously healthy female who presented with a basilar artery occlusion and pontine ischemic stroke. She was treated with intravenous t-PA approximately 4 hours after the onset of symptoms. The patient demonstrated a remarkable recovery 6 hours after onset of her symptoms and had minimal deficits on discharge from the hospital 1 week later. She was found to have a lupus anticoagulant and was heterozygous for the prothrombin gene G2010A mutation. These were likely contributing causes for her stroke. She was also homozygous for plasminogen activator inhibitor 1 (PAI-1) 4G/4G, which at present is a controversial stroke risk factor.
Authors:
Jason W Heil; Laurel Malinowski; Andrea Rinderknecht; Joseph P Broderick; David Franz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of child neurology     Volume:  23     ISSN:  1708-8283     ISO Abbreviation:  J. Child Neurol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-01     Completed Date:  2009-01-08     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8606714     Medline TA:  J Child Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1049-53     Citation Subset:  IM    
Affiliation:
University of Cincinnati, Department of Neurology, Cincinnati, Ohio 45267-0525, USA. heiljw@email.uc.edu.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Basilar Artery / drug effects,  pathology,  physiopathology
Blood Coagulation Disorders, Inherited / complications*,  genetics*,  physiopathology
Brain Stem Infarctions / drug therapy,  genetics,  physiopathology
Crohn Disease
DNA Mutational Analysis
Female
Fibrinolytic Agents / administration & dosage
Genetic Predisposition to Disease / genetics*
Genetic Testing
Genotype
Humans
Lupus Coagulation Inhibitor / blood,  genetics
Mutation / genetics
Plasminogen Activator Inhibitor 1 / genetics
Prothrombin / genetics
Recovery of Function / drug effects
Time Factors
Tissue Plasminogen Activator / administration & dosage*
Treatment Outcome
Vertebrobasilar Insufficiency / drug therapy*,  genetics*,  physiopathology
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Lupus Coagulation Inhibitor; 0/Plasminogen Activator Inhibitor 1; 9001-26-7/Prothrombin; 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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