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Complete Recovery after Early Intraarterial Recombinant Tissue Plasminogen Activator Thrombolysis of Carotid T Occlusion

Alejandro A. Rabinsteina, Eelco F. M. Wijdicksa and Douglas A. Nicholsb

a Department of Neurology, Mayo Clinic, Rochester, MN
b Department of Radiology, Mayo Clinic, Rochester, MN



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  		FIG 1. Angiograms from the case of a 26-year-old previously healthy woman who presented to the emergency department with acute onset of left-sided weakness and dysarthria.

A, Cerebral angiogram (anteroposterior [left] and lateral views [right]), obtained after injection of the right ICA and before thrombolysis, shows complete occlusion of the supraclinoid right ICA distal to the anterior choroidal artery. There is no opacification of the A1 and M1 segments due to extension of the thrombus into those segments.

B, Cerebral angiogram (anteroposterior [left] and lateral [right] views), obtained after injection of the right ICA and after intraarterial thrombolysis with 26 mg of rtPA, shows complete recanalization of all major arterial branches with only residual lack of opacification of a right frontal M4 branch.



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  		FIG 2. Fluid-attenuated inversion recovery (128/6000 [TR/TE]) MR image of the brain shows small and scattered areas of hyperintensity in the right MCA territory as the only residual sequelae 4 days after the event.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X