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From the Service d’Urgences Neurovasculaires (Drs. Derex, Nighoghossian, Honnorat, Neuschwander, and Trouillas) and the Service de Neuroradiologie (Drs. Turjman, Hermier, and Froment), Hôpital Neurologique, Lyon, France.
Address correspondence and reprint requests to Dr. Laurent Derex, Service d’Urgences Neurovasculaires, Hôpital Neurologique Pierre Wertheimer, 59 Boulevard Pinel, 69003 Lyon, France; e-mail: lderex{at}yahoo.com
The authors describe the outcomes in 11 patients who had acute ischemic stroke related to internal carotid artery (ICA) dissection and were treated with IV tissue plasminogen activator (tPA). One symptomatic intracerebral hemorrhage occurred 36 hours after tPA was given. The mean day 90 modified Rankin Scale (m-RS) score was 2.4 (±1.6). No death was observed at 3 months. Four patients of 11 (36.4%) made an excellent recovery (day 90 m-RS score: 0 to 1). This study demonstrates the feasibility of IV thrombolysis with tPA (0.8 mg/kg) in ischemic stroke related to ICA dissection within the first 7 hours.
Key words: Internal carotid dissection—Acute ischemic stroke—Tissue plasminogen activator—Thrombolytic therapy.
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