Transcranial sonographic monitoring during thrombolytic therapy

Two patients with acute occlusion of the middle cerebral artery (MCA) were treated with intravenous alteplase. Neurovascular monitoring, which was performed simultaneously via transcranial sonography, enabled precise documentation of MCA recanalization. This information was used to tailor the dosage and duration of alteplase treatment. Sonographic information concerning the arterial segments involved in the occlusive process, the actual hemodynamic status, and the collateral blood supply may help to identify those patients most likely to benefit from thrombolysis.