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[Intra-arterial thrombolysis in basilar artery thrombosis. Recovery of two patients with locked-in syndrome].

Abstract
Locked-in syndrome is a dramatic clinical condition, the patient is awake, can listen and breath, but is unable to move any muscle, conserving only the vertical eye movements. The most common cause of locked-in syndrome is the thrombosis of the basilar artery and commonly leads to death, frequently due to pneumonia. Intravenous and intra arterial thrombolysis have been used successfully in a selective group of patients with ischemic stroke. There is only one report of two patients with locked-in syndrome who were treated successfully with intra arterial thrombolysis. Other authors, based in their experiences, do not recommend this treatment. We report two female patients aged 63 and 26 years, with Locked-in syndrome due to a basilar thrombosis who were treated successfully with intra arterial thrombolysis using recombinant tissue plasminogen activator (r-TPA). The lapses between the onset of the symptoms and thrombolysis were 5 and 8 hours respectively. A complete recanalization was obtained in both patients during the thrombolysis. One year after, the first patient has only a moderate ataxia, walking with assistance and the other has a normal neurological examination.
AuthorsPatricio Mellado, Patricio Sandoval, José Tevah, Isidro Huete, Luis Castillo
JournalRevista medica de Chile (Rev Med Chil) Vol. 132 Issue 3 Pg. 357-60 (Mar 2004) ISSN: 0034-9887 [Print] Chile
Vernacular TitleTrombolisis intraarterial en trombosis de la arteria basilar. Recuperación de dos pacientes con síndrome de enclaustramiento.
PMID15376574 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Recombinant Proteins
  • Heparin
  • Tissue Plasminogen Activator
Topics
  • Adult
  • Basilar Artery
  • Female
  • Heparin (therapeutic use)
  • Humans
  • Infusions, Intra-Arterial
  • Intracranial Thrombosis (drug therapy)
  • Middle Aged
  • Quadriplegia (complications)
  • Recombinant Proteins
  • Stroke (drug therapy)
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator (therapeutic use)

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