Hyperacute ischemic stroke without lesions on diffusion-weighted imaging in a patient treated with rtPA thrombolysis
نویسندگان
چکیده
KEY CLINICAL MESSAGE We report a comatose patient with severe neurological deficits who was without spontaneous language or movement. He had a good response to recombinant tissue plasminogen activator (rtPA) thrombolysis even though there were no detectable lesions on diffusion-weighted imaging (DWI). DWI is very sensitive for diagnosing hyperacute ischemic stroke, and rtPA thrombolysis is the best treatment. However, rtPA thrombolysis in ischemic stroke patients without lesions on DWI has rarely been reported.
منابع مشابه
Monitoring intravenous recombinant tissue plasminogen activator thrombolysis for acute ischemic stroke with diffusion and perfusion MRI.
BACKGROUND AND PURPOSE Intravenous recombinant tissue plasminogen activator (rtPA) administration is an effective therapy for ischemic stroke when initiated within 3 hours and possibly up to 6 hours after symptom onset. To improve patient selection, a fast diagnostic tool that allows reliable diagnosis of hemorrhage and ischemia, vessel status, and tissue at risk at an early stage may be useful...
متن کاملIntra-arterial rtPA treatment of stroke assessed by diffusion- and perfusion-weighted MRI.
BACKGROUND Diffusion-weighted MRI (DWI) and perfusion-weighted MRI (PWI) are new techniques that can be used for the evaluation of acute ischemic stroke. However, their potential role in the management of patients treated with recombinant tissue plasminogen activator (rtPA) has yet to be determined. CASE DESCRIPTION The authors present the case of a 73-year-old man who was treated with intra-...
متن کاملHemorrhagic risk of recent silent cerebral infarct on prethrombolysis MR imaging in acute stroke.
BACKGROUND AND PURPOSE EIH is a rare complication after thrombolysis in patients with acute stroke, occurring in brain regions without visible ischemic change on pretreatment imaging. RSCIs can be detected by multimodal MR imaging and might be associated with an increased risk of HT postthrombolysis, related to BBBD. We aimed to assess the incidence of RSCI on pretreatment MR imaging and the su...
متن کاملLarge ischemic lesions on diffusion-weighted imaging done before intravenous tissue plasminogen activator thrombolysis predicts a poor outcome in patients with acute stroke.
BACKGROUND AND PURPOSE MRI is useful for detecting early ischemic lesions before administration of tissue plasminogen activator in patients with hyperacute ischemic stroke. However, it is unclear whether early ischemic change seen on diffusion-weighted imaging (DWI) can be used to predict patient outcomes. METHODS Consecutive patients with anterior circulation ischemic stroke treated with tis...
متن کاملFeasibility and practicality of MR imaging of stroke in the management of hyperacute cerebral ischemia.
BACKGROUND AND PURPOSE Neuroimaging techniques such as diffusion- and perfusion-weighted MR imaging have been proposed as tools for advanced diagnosis in hyperacute ischemic stroke. There is, however, substantial doubt regarding the feasibility and practicality of applying MR imaging for the diagnosis of stroke on a routine basis, especially with respect to possible delay for specific treatment...
متن کامل