This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (38)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Thrombolysis  • Cerebrovascular Disease  • Cardiovascular System  • Alert me on articles by topic  Social Bookmarking   What's this?

Martin Grond, MD; Jobst Rudolf, MD; Susanne Schmülling, MD; Christoph Stenzel, MD; Michael Neveling, MD; Wolf-Dieter Heiss, MD

Arch Neurol. 1998;55:466-469.

Background  The optimal therapy of vertebrobasilar ischemic stroke is under debate. In the case of underlying basilar artery occlusion, intra-arterial thrombolysis is recommended. Because this pathologic condition is rarely found and the procedure is time consuming and restricted to specialized centers, the question arises whether early intravenous thrombolysis could also effectively be applied in vertebrobasilar ischemic stroke.

Objective  To determine if early intravenous thrombolysis could be used effectively in vertebrobasilar ischemic stroke.

Design  A case series of 12 consecutive patients with acute vertebrobasilar ischemia were followed up 3 months after thrombolytic treatment at the Department of Neurology of the University Hospital of Cologne, Cologne, Germany, a primary care and referral center.

Methods  Patients with clinically diagnosed moderate to severe vertebrobasilar ischemic stroke with clearly determined symptom onset were treated with intravenous recombinant tissue-type plasminogen activator within 3 hours after symptom onset following a protocol similar to that of the National Institute of Neurological Disorders and Stroke study.

Results  On admission, 7 patients exhibited moderate to severe brainstem symptoms without impairment of consciousness and 5 patients had impairment of consciousness, of whom 2 were comatose. Of 12 patients, 10 had a favorable outcome after 3 months defined as full independence (Barthel index score of 100) or return to premorbid condition. One patient had a poor outcome with complete dependency due to reocclusion after primarily successful thrombolysis, and 1 patient died of severe brainstem infarction and additional space occupying parietal hemorrhage.

Conclusion  Favorable outcome could be achieved in the majority of 12 consecutive patients with moderate to severe vertebrobasilar ischemic stroke treated with intravenous recombinant tissue-type plasminogen activator within 3 hours after symptom onset.

From the Department of Neurology, University Hospital of Cologne, Cologne, Germany.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED ARTICLES

Stroke 1998
Roger N. Rosenberg
Arch Neurol. 1998;55(4):448.
EXTRACT | FULL TEXT  

Vertebrobasilar Disease and Thrombolytic Treatment
Louis R. Caplan
Arch Neurol. 1998;55(4):450-451.
EXTRACT | FULL TEXT  

Proximal Extracranial Vertebral Artery Disease in the New England Medical Center Posterior Circulation Registry
Robert J. Wityk, Hui M. Chang, Axel Rosengart, Wen-Chaing Han, L. Dana DeWitt, Michael S. Pessin, and Louis R. Caplan
Arch Neurol. 1998;55(4):470-478.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Brain Stem Diffusion-Weighted Imaging Lesion Score: A Potential Marker of Outcome in Acute Basilar Artery Occlusion
Cho et al.
Am. J. Neuroradiol. 2009;30:194-198.
ABSTRACT | FULL TEXT  

Initial Glasgow Coma Scale Score Predicts Outcome Following Thrombolysis for Posterior Circulation Stroke
Tsao et al.
Arch Neurol 2005;62:1126-1129.
ABSTRACT | FULL TEXT  

Vertebrobasilar Disease
Savitz and Caplan
NEJM 2005;352:2618-2626.
FULL TEXT  

Options for Recanalization Therapy in Basilar Artery Occlusion
Lindsberg et al.
Stroke 2005;36:203-204.
FULL TEXT  

Intravenous r-TPA in vertebrobasilar acute infarcts
Montavont et al.
Neurology 2004;62:1854-1856.
ABSTRACT | FULL TEXT  

Detection of Reversed Basilar Flow With Power-Motion Doppler After Acute Occlusion Predicts Favorable Outcome
Ribo et al.
Stroke 2004;35:79-82.
ABSTRACT | FULL TEXT  

Heralding manifestations of basilar artery occlusion with lethal or severe stroke
von Campe et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:1621-1626.
ABSTRACT | FULL TEXT  

Successful Endovascular Therapy for Acute Basilar Thrombosis in an Adolescent
Kirton et al.
Pediatrics 2003;112:e248-251.
ABSTRACT | FULL TEXT  

Imaging-Based Decision Making in Thrombolytic Therapy for Ischemic Stroke: Present Status
Schellinger et al.
Stroke 2003;34:575-583.
ABSTRACT | FULL TEXT  

Treatment of Acute Ischemic Stroke
Brott and Bogousslavsky
NEJM 2000;343:710-722.
FULL TEXT  

Stroke 1998
Rosenberg
Arch Neurol 1998;55:448-448.
FULL TEXT  

Vertebrobasilar Disease and Thrombolytic Treatment
Caplan
Arch Neurol 1998;55:450-451.
FULL TEXT  

Treatment of Acute Basilar Artery Thrombosis with a Combination of Systemic Alteplase and Tirofiban, a Nonpeptide Platelet Glycoprotein IIb/IIIa Inhibitor: Report of Four Cases
Junghans et al.
Radiology 2001;221:795-801.
ABSTRACT | FULL TEXT