THROMBOLYTIC TREATMENT AND DRAMATIC IMPROVEMENT OF THE CLINICAL PICTURE IN A PATIENT WITH ACUTE OCCLUSION OF THE MIDDLE CEREBRAL ARTERY FOLLOWED BY TRANSCRANIAL DOPPLER SONOGRAPHY
DOI:
https://doi.org/10.6016/ZdravVestn.2289Keywords:
acute ischemic cerebral stroke, occlusion of middle cerebral artery, thrombolysis, dramatic clinical improvement, transcranial Doppler sonographyAbstract
Background. Thrombolytic treatment of ischemic cerebral stroke by means of a recombinant tissue plasminogen activator can be very successful in selected patients. Transcranial Doppler sonography allows us to establish a total occlusion of the middle cerebral artery and to follow continuously the process of recanalization during and immediately after thrombolysis.
Patient and methods. 62-year-old male patient with acute occlusion of the middle cerebral, artery at its bifurcation resulting in left-side hemiplegia and left-side sensibility disorders is presented. The process of recanalization was followed by means of transcranial Doppler sonography. Five minutes after the termination of thrombolysis complete recanalization resulted in a dramatic improvement of the neurological clinical picture. After several days of hospitalization the neurologically intact patient was discharged from hospital.
Conclusions. In patients with ischemic cerebral stroke the mechanism of dramatic clinical improvement following thrombolytic treatment is associated with complete recanalization of the vascular occlusion which can be objectivized by transcranial Doppler sonography
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