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COMMENTS AND OPINIONS
Thrombolysis, Fluctuations, and Protocol Expansions—Reply
Ozcan Ozdemir, MD;
Vadim Beletsky, MD, PhD;
Richard Chan, MD, FRCP(Edin);
Vladimir Hachinski, MD, FRCPC, DSc
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In reply
We greatly appreciate the comments by Calleja et al and Totah on our article.1 Calleja et al described a case with clinical fluctuations that was successfully treated by rtPA and suggested that recanalization of thrombus within the distal pial arteries may enhance pial collaterals and thereby stop stereotypical uncountable fluctuations. We agree with their hypothesis and their contribution to our discussion.
Small pial vessels along the surface of the brain provide collaterals through different arterial watershed regions. Moreover, good collateral circulation through the circle of Willis and pial collateral circulation are predictors of good outcome in patients with stroke.2-3 Disruption of proximal thrombus spontaneously or with thrombolysis in major vessels can predispose to break up embolism and subsequent pial vessel occlusions. Even in the setting of complete proximal vessel recanalization with thrombolysis, . . . [Full Text of this Article] AUTHOR INFORMATION
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RELATED LETTERS
Thrombolysis in Patients With Marked Clinical Fluctuations in Neurologic Status Due to Cerebral Ischemia
Ozcan Ozdemir, Vadim Beletsky, Richard Chan, and Vladimir Hachinski
Arch Neurol. 2008;65(8):1041-1043.
ABSTRACT
| FULL TEXT
Thrombolysis, Fluctuations, and Protocol Expansions
Abraham Totah
Arch Neurol. 2009;66(3):418.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Thrombolysis in Patients With Marked Clinical Fluctuations in Neurologic Status Due to Cerebral Ischemia
Ozcan Ozdemir, Vadim Beletsky, Richard Chan, and Vladimir Hachinski
Arch Neurol. 2008;65(8):1041-1043.
ABSTRACT
| FULL TEXT
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