on December 8, 2005
Published online before print December 8, 2005, doi: 10.1161/01.STR.0000195171.29940.79
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Submitted on July 21, 2005
From the Departments of Neurology (R.V., C.J., W.H.) and Neuroradiology (B.K.), Ruprecht-Karls University Heidelberg, Germany. * To whom correspondence should be addressed. E-mail: roland_veltkamp{at}med.uni-heidelberg.de.
Background and Purpose--Patients with high-grade basilar artery stenosis secondary to thromboembolism are at high risk of developing subsequent vessel occlusion. Optimal medical management of this condition is unclear. Summary of Case--We present a patient with a small subacute brain stem infarction and filiform distal basilar residual lumen attributable to arterioarterial or cardiogenic embolism. Beginning 3 days after symptom onset, low-dose intravenous thrombolysis with 0.125 mg/kg recombinant tissue plasminogen activator was continuously infused for 48 hours. Follow-up magnetic resonance angiography revealed complete resolution of the embolus. No further cerebral ischemic episodes occurred during 3-month follow-up, and the basilar artery remained patent. Conclusion--Our observation suggests a potential for prolonged low-dose intravenous thrombolysis in basilar artery embolism, but further data are needed to judge the effectiveness and risk of this intervention.
Revised on August 26, 2005
Accepted on September 6, 2005
Prolonged Low-Dose Intravenous Thrombolysis in a Stroke Patient With Distal Basilar Thrombus
Roland Veltkamp MD*;
Key words: ischemia • magnetic resonance imaging • reperfusion • thrombolysis
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