Thrombolysis beyond the guidelines: two treatments in one subject within 90 hours based on a modified magnetic resonance imaging brain clock concept

Stroke. 2005 Nov;36(11):e162-4. doi: 10.1161/01.STR.0000185799.22645.8a. Epub 2005 Oct 6.

Abstract

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.

Conclusions: 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.

Publication types

  • Case Reports

MeSH terms

  • Brain / pathology*
  • Brain Ischemia / therapy
  • Humans
  • Male
  • Middle Aged
  • Middle Cerebral Artery / pathology
  • Recurrence
  • Stroke / therapy*
  • Thrombolytic Therapy / methods*
  • Time Factors