Transcranial Doppler sonography monitoring of local intra-arterial thrombolysis in acute occlusion of the middle cerebral artery.
نویسندگان
چکیده
BACKGROUND AND PURPOSE The aim of this study is to report on the use of transcranial Doppler ultrasonography as a noninvasive diagnostic monitoring tool during local intra-arterial thrombolysis in a patient with acute embolic occlusion of the middle cerebral artery. CASE DESCRIPTION We describe a 41-year-old woman with mitral valve stenosis suffering from embolism of the middle cerebral artery. Local thrombolysis was performed with tissue plasminogen activator at a dosage of 0.05 mg/kg/hr. Progress of the thrombolysis was monitored by transcranial Doppler. The steps of recanalization could be ascertained by transcranial ultrasound showing a hemodynamically relevant residual stenosis after the first 120 minutes and complete patency of the M1 segment of the middle cerebral artery 180 minutes later. One branch of the middle cerebral artery still showed a filling defect. CONCLUSIONS Our report demonstrates the potential usefulness of transcranial Doppler monitoring during thrombolysis of a proximal occlusion of the middle cerebral artery for guiding the treatment by assessing the reperfusion of the obstructed artery.
منابع مشابه
Blood Viscosity and Cerebral Blood Flow Walzl and coworkers reported an improvement of neurological function following heparin-induced extracorporeal low-density lipoprotein precipitation (HELP) in a mixed group of acute stroke
1. Davis SM, Chua MG, Lichtenstein M, Rossiter SC, Binns D, Hopper JL. Cerebral hypoperfusion in stroke prognosis and brain recovery. Stroke. 1993;24:1691-1696. 2. Alexandrov AV, Ehrlich LE, Bladin CF, Norris JW. Cerebral perfusion index: a new marker for clinical outcome in acute stroke. J Neuroimaging. 1993;3:209-215. 3. Alexandrov AV, Bladin CF, Ehrlich LE, Norris JW. Cerebral perfusion inde...
متن کاملComparison of cerebral angiography and transcranial Doppler sonography in acute stroke.
We compared digital intra-arterial angiography and transcranial Doppler sonography in acute cerebral ischemia as part of a wider study on a continuous series of 48 patients with acute focal cerebral ischemia in the carotid territory, observed within 4 hours of the onset of symptoms. The most significant Doppler findings of the middle cerebral artery included no detection of the artery when occl...
متن کاملTranscranial doppler sonography diagnostic value for the cerebral flow velocity changes in the interictal phase of classic migraine
Background: An imbalance of the cerebrovascular response during functional activation of the brain has been postulated as a factor in the pathophysiology of migraine. The purpose of this study was to determine the transcranial doppler sonography (TDS) diagnostic value for the cerebral flow velocity changes in the interictal phase of classic migraine. Methods: This study was carried out on 46 pa...
متن کاملReal-time monitoring of blood flow changes during intravenous thrombolysis for acute middle cerebral artery occlusion.
Dear Editor, We report a 62-year-old Chinese man who presented 90 minutes after right-sided weakness and inability to speak of sudden onset. He had been taking medications for hypertension and hypercholesterolaemia for 5 years. On examination, he was conscious with an irregularly irregular pulse and blood pressure of 168/95 mmHg. Neurological examination was remarkable for a forced left gaze, g...
متن کاملIntravenous versus combined (intravenous and intra-arterial) thrombolysis in acute ischemic stroke: a transcranial color-coded duplex sonography--guided pilot study.
BACKGROUND AND PURPOSE Determine feasibility and safety of intravenous (IV) versus combined (IV-IA [intra-arterial]) thrombolysis guided by transcranial color-coded duplex sonography (TCCD). METHODS Thirty-three patients eligible for IV thrombolysis, within 3 hours of onset of symptoms, with occlusion in middle cerebral artery territory (TCCD monitoring, thrombolysis in brain ischemia [TIBI] ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Stroke
دوره 23 2 شماره
صفحات -
تاریخ انتشار 1992