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Updated: Jul 26, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Thrombolytic therapy in vertebrobasilar occlusion
D Thyagarajan1, R J Stark, J Frayne
1Department of Neurology, Alfred Hospital, Melbourne.
Clinical and Experimental Neurology
|January 1, 1992
Summary
Intra-arterial streptokinase (SK) effectively treated thrombotic vertebrobasilar occlusions in 3 of 4 patients, restoring blood flow and improving neurological function. Early intervention is key for successful thrombolytic therapy in brainstem ischemia.
Area of Science:
- Neurology
- Vascular Medicine
- Interventional Radiology
Background:
- Vertebrobasilar occlusions cause severe brainstem ischemia.
- Standard anticoagulation with heparin may be insufficient.
- Thrombolytic therapy offers a potential treatment avenue.
Observation:
- Four patients with thrombotic/embolic vertebrobasilar occlusions received intra-arterial streptokinase (SK).
- Heparin anticoagulation was used prior to SK infusion.
- Treatment was administered at the Alfred Hospital since 1983.
Findings:
- Three patients showed immediate neurological improvement and vessel reperfusion.
- Two patients experienced recurrent occlusions but recovered without further thrombolysis.
- One patient treated 12 days post-stroke showed no improvement or reperfusion.
- Complications included nausea, minor bleeding, and asymptomatic cerebellar infarction.
Implications:
- Intra-arterial SK demonstrates significant benefit in acute vertebrobasilar occlusions.
- Timely administration of SK is crucial for successful outcomes.
- Further research into optimal dosing and patient selection is warranted.
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