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Related Experiment Videos

Late intra-arterial thrombolysis.

C Stapf1, R S Marshall, J P Mohr

  • 1Stroke Center/The Neurological Institute, Columbia University College of Physicians & Surgeons, New York, NY, USA. cs585@columbia.edu

European Journal of Medical Research
|July 21, 2000
PubMed
Summary

Intra-arterial thrombolysis may be effective for stroke patients even after six hours if they have a normal brain scan and incomplete symptoms. This suggests a potentially longer treatment window for select stroke cases.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Interventional Neurology

Background:

  • Stroke treatment typically has a limited time window for intervention.
  • Intra-arterial thrombolysis is a critical treatment for acute ischemic stroke.
  • Assessing eligibility for thrombolysis often relies on time from symptom onset and brain imaging.

Observation:

  • A 70-year-old woman presented with a progressive dominant hemisphere syndrome, mild hemiparesis, and a normal brain scan over 3 hours post-stroke.
  • Angiography revealed occlusion of the left anterior cerebral artery and middle cerebral artery trifurcation, with the rolandic artery patent.
  • Intra-arterial thrombolysis was initiated more than 6 hours after symptom onset.

Findings:

  • Successful recanalization was achieved following intra-arterial thrombolysis.

Related Experiment Videos

  • The patient recovered with transcortical motor aphasia but no motor deficit.
  • The treatment demonstrated significant neurological improvement despite the extended time frame.

    • Implications:

    • A normal brain scan and incomplete hemispheric syndrome may suggest an extended therapeutic window for intra-arterial thrombolysis.
    • This case challenges conventional time-based limitations for acute stroke interventions.
    • Further research into extended time-windows for thrombolysis in specific stroke profiles is warranted.