scholarly journals A patient with a middle cerebral artery embolism and widespread early CT signs who recovered almost completely following superselective thrombolytic therapy

2008 ◽  
Vol 15 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Takeshi Takahashi ◽  
Tomohiro Takita ◽  
Yanosuke Kozaki ◽  
Masahiro Harada ◽  
Shoko Kodama ◽  
...  
Stroke ◽  
1993 ◽  
Vol 24 (4) ◽  
pp. 615-616 ◽  
Author(s):  
J A Egido ◽  
R Arroyo ◽  
A Marcos ◽  
I Jiménez-Alfaro

1997 ◽  
Vol 6 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Hajime Ohta ◽  
Kiyotaka Yokogami ◽  
Shinichi Nakano ◽  
Tomokazu Goya ◽  
Shinichiro Wakisaka

1991 ◽  
Vol 1 (2) ◽  
pp. 63-67 ◽  
Author(s):  
Camllo R. Gomez ◽  
Stephen K. Burger ◽  
Robert R. Smith ◽  
Alexandros Powers ◽  
Michael Graeber

2020 ◽  
Vol 14 (11) ◽  
pp. 522-527
Author(s):  
Naoki Kato ◽  
Takeshi Kinkori ◽  
Kenichi Watanabe ◽  
Yuji Kibe ◽  
Toru Arima

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 137-144
Author(s):  
T. Inagaki ◽  
K. Saito ◽  
T. Okuyama ◽  
A. Hirano ◽  
A. Takahashi ◽  
...  

We have evaluated the usefulness of diffusion-weighted MRI (DWI) for determining an indication of emergent thrombolytic revascularization therapy in patients with acute occlusive cerebrovascular disease. Out of twenty-nine patients with acute occlusion of the middle cerebral artery within six hours after the onset, nine patients performed thrombolytic therapy. In results, seven patients of them obtained revascularization and good outcome. DWI findings on admission were correlated to the cerebral blood flow measured by SPECT and classified into four types; Type 1: no high intensity, Type 2: high intensity only in the perforator's territory, Type 3: limited high intensity in the cortical branches' territory, Type 4: extended high intensity. As presented cases, the high intensity area seen on DWI became obvious infarction regardless of implementation of revascularization therapy. However, thrombolytic therapy could rescue the area of low CBF on SPECT and could improve clinical symptoms. We considered that the area of low CBF without high intensity on DWI was “ischemic penumbra” and classification of DWI findings could be a valuable indicator in determining an indication of thrombolytic therapy.


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tudor Jovin ◽  
Brian Jankowitz ◽  
Ashutosh P Jadhav

Background and Purpose: Cerebral ischemic attacks are classically known to cause either permanent injury in the case of ‘stroke’ or transient dysfunction without permanent injury in the case of ‘TIA’. The latter occurs due to timely restoration of cerebral blood flow and implies a spontaneous process. With thrombolytic therapy (intravenous or intra-arterial) complete reperfusion is possible and can lead in some patients to complete reversal of the ischemic insult both clinically and radiographically. This entity is inadequately characterized by the current stroke terminology. Methods: A retrospective review of a prospectively maintained database identified 800 patients who underwent acute endovascular reperfusion therapy. Inclusion criteria were: complete clinical recovery without evidence of infarction on follow up MRI (DWI sequence). Results: We identified 8 patients. Intravenous alteplase followed by intra-arterial therapy was administered in 37.5% of cases. Admission NIHSS ranged from 8-21 and recanalization occurred between 45-490 minutes of symptom onset. The site of occlusion was as follows: left internal carotid artery terminus (2, 25%), middle cerebral artery M1 segment (5, 62.5%) and middle cerebral artery M2 segment (1, 12.5%). Conclusions: A hitherto unreported condition of complete clinical and radiographic recovery after reperfusion therapy for large vessel intracranial occlusion is being described. Review of an endovascular database comprising 800 consecutive cases, revealed that the incidence of this entity is 1%. We postulate that in parallel to an increase in efficacy and utilization of revascularization modalities along with an increase in assessment of vessel patency prior to intravenous thrombolysis, recognition of this phenomenon will increase and propose the term ‘Reversed’ Ischemic Attack (RIA) to address a deficiency in terminology currently associated with this condition.


Nosotchu ◽  
2014 ◽  
Vol 36 (4) ◽  
pp. 271-274
Author(s):  
Ryu Ubagai ◽  
Takehiro Suyama ◽  
Shin Yamashita ◽  
Rin Shimozato ◽  
Masahiro Murakami ◽  
...  

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