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[A case of successful thromobolytic therapy in a patient with cerebral embolism during angiography]
T Uesaka1, T Inamura, T Kawamura
1Department of Neurosurgery, Kyushu University Hospital.
We report a case of successful thromobolytic therapy in a patient with cerebral embolism during angiography. A 57 year-old male lost his consciousness during angiography. His neurologic symptoms were semi-comatose and right oculomotor palsy. According to these symptoms, we estimated the lesion in the right midbrain. Immediately after we denied a cerebral hemorrhage by computed tomography, we infused 60,000 u of urokinase intravenously within an hour from the onset followed by diffusion weighted magnetic resonance imaging (DW-MRI). DW-MRI showed hyper-intense lesion in the midbrain. We sequentially performed thrombolytic therapy with urokinase by selective cerebral angiography within three hours from the onset. His symptoms gradually resolved, but his consciousness was still confused state. His all neurologic symptom completely resolved in the next day after hyperbaric oxygenation therapy.
We report a case of successful thromobolytic therapy in a patient with cerebral embolism during angiography. A 57 year-old male lost his consciousness during angiography. His neurologic symptoms were semi-comatose and right oculomotor palsy. According to these symptoms, we estimated the lesion in the right midbrain. Immediately after we denied a cerebral hemorrhage by computed tomography, we infused 60,000 u of urokinase intravenously within an hour from the onset followed by diffusion weighted magnetic resonance imaging (DW-MRI). DW-MRI showed hyper-intense lesion in the midbrain. We sequentially performed thrombolytic therapy with urokinase by selective cerebral angiography within three hours from the onset. His symptoms gradually resolved, but his consciousness was still confused state. His all neurologic symptom completely resolved in the next day after hyperbaric oxygenation therapy.