Abstract
Cervical artery dissection is an important cause of stroke in young patients and accounts of 10%–20% of stroke or TIA in patients aged less than 50 years. Basilar artery occlusion (BAO) is an infrequent cause of acute stroke, which invariably leads to death or long-term disability if not recanalized. We describe three patients with BAO caused by vertebral dissection, successfully treated with intra-arterial thrombolysis. The lysis of the occluding embolus was obtained by injection of the thrombolytic drug directly or near the thrombus without haemor-rhagic complications. Our cases confirm the safety and efficacy of intra-arterial thrombolysis in patients with BAO due to a vertebral artery dissection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baird TA, Muir KW, Bone I (2004) Basilar artery occlusion. Neurocritical Care 3:319–330
Ferbert A, Bruckmann H, Drummen R (1990) Clinical features of proven basilar artery occlusion. Stroke 21:1135–1142
Brandt T, von Kummer R, Müller-Kuppers M, Hacke W (1996) Thrombolytic therapy of acute basilar artery occlusion: variables affecting recanalization and outcome. Stroke 27:875–881
Arnold M, Nedeltchev K, Schroth G et al (2004) Clinical and radiological predictors of recanalization and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysis. J Neurol Neurosurg Psychiatry 75:857–862
Lindsberg PJ, Mattle HP (2006) Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 37:922–928
Schievink WI (2001) Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 344:898–906
Ramgren B, Cronqvist M, Romner B et al (2005) Vertebrobasilar dissection with subarachnoid hemorrhage: a retrospective study of 29 patients. Neuroradiology 47:97–104
Price R, Sellar R, Leung C, O’sullivan M (1998) Traumatic vertebral arterial dissection and vertebrobasilar arterial thrombosis successfully treated with endovascular thrombolysis and stenting. Am J Neuroradiol 19:1677–1680
Arnold M, Nedeltchev K, Sturzenegger M (2002) Thrombolysis in patients with acute stroke caused by cervical artery dissection. Arch Neurol 59:549–553
Eckert B, Kucinski T, Pfeiffer G et al (2002) Endovascular therapy of acute vertebrobasilar occlusion: early treatment onset as the most important factor. Cerebrovasc Dis 14:42–50
Sliwka U, Mull M, Syelzer A et al (2001) Long-term follow-up of patients after intra-arterial thrombolytic therapy of acute vertebrobasilar artery occlusion. Cerebrovasc Dis 12:214–219
Bissay F, Allard S, Van Tussenbroek F et al (2004) Vertebral artery dissection complicated by a thrombosis of the basilar artery was successfully treated with endovascular thrombolysis. Eur Neurol 51:110–113
Ostrem JL, Saver JL, Alger JR et al (2004) Acute basilar artery occlusion: diffusion-perfusion MRI characterization of tissue salvage in patients receiving intra-arterial stroke therapies. Stroke 35:e30–e34
Ciccone A, Valvassori L, Gasparotti R et al (2007) Debunking 7 myths that hamper the realization of randomized controlled trials on intra-arterial thrombolysis for acute ischemic stroke. Stroke 38:2191–2195
Hacke W, Zeumer H, Ferbert A et al (1998) Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 19:1216–1222
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cerrato, P., Berardino, M., Bottacchi, E. et al. Vertebral artery dissection complicated by basilar artery occlusion successfully treated with intra-arterial thrombolysis: three case reports. Neurol Sci 29, 51–55 (2008). https://doi.org/10.1007/s10072-008-0861-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-008-0861-1