Published Online
on October 6, 2005

A more recent version of this article appeared on November 1, 2005

This Article Full Text (PDF) All Versions of this Article: 36/11/e162    most recent 01.STR.0000185799.22645.8av1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Topakian, R. Articles by Aichner, F. T. Search for Related Content PubMed PubMed Citation Articles by Topakian, R. Articles by Aichner, F. T. Pubmed/NCBI databases Medline Plus Health Information Stroke Related Collections Acute Cerebral Infarction Thrombolysis

Submitted on May 11, 2005
Revised on August 12, 2005
Accepted on August 23, 2005

Thrombolysis Beyond the Guidelines. Two Treatments in One Subject Within 90 Hours Based on a Modified Magnetic Resonance Imaging Brain Clock Concept

Raffi Topakian MD^*; Franz Gruber MD; Franz A. Fellner MD; Hans-Peter Haring MD; and Franz T. Aichner MD

From the Departments of Neurology (R.T., F.G., H.-P.H., F.T.A.) and Radiology (F.A.F.), Hospital Wagner-Jauregg Linz, Austria.

^* To whom correspondence should be addressed. E-mail: raffi.topakian{at}aon.at.

Background and Purpose--We report the first case of 2 intravenous thrombolysis treatments within 90 hours in a patient with early recurrent stroke.

Summary of Review--A 50-year-old man had improved significantly after intravenous thrombolysis for acute stroke. On the fourth day, he deteriorated dramatically because of recurrent stroke. Evidence of vessel reocclusion and profound perfusion/diffusion mismatch constituted the rationale for a second thrombolysis treatment, which resulted in vessel recanalization and significant neurologic improvement.

Conclusion--The pathophysiological information obtained by multimodal magnetic resonance imaging may suit as a brain clock when repeat thrombolysis treatment is considered for early recurrent stroke.

Key words: magnetic resonance imaging • stroke • thrombolysis

This article has been cited by other articles:

				J. De Keyser, Z. Gdovinova, M. Uyttenboogaart, P. C. Vroomen, and G. J. Luijckx Intravenous Alteplase for Stroke: Beyond the Guidelines and in Particular Clinical Situations Stroke, September 1, 2007; 38(9): 2612 - 2618. [Abstract] [Full Text] [PDF]

				M. Ribo, C. A. Molina, R. Topakian, H.-P. Haring, F. T. Aichner, F. Gruber, and F. A. Fellner Repeated Tissue Plasminogen Activator Treatment for Early Stroke Recurrence: Protocol Violation Is Not an Option Stroke, May 1, 2006; 37(5): 1151 - 1153. [Full Text] [PDF]