Outcome of Acute Vertebrobasilar Occlusions Treated with Intra-Arterial Fibrinolysis in 180 Patients
G. Schulte-Altedorneburga,
G.F. Hamannb,e,
M. Mullc,
D. Kühned,
M. Liebetraub,e,
W. Weberd,
H. Brückmanna and
T.E. Mayera
a Department of Neuroradiology, University of Munich, Klinikum Grosshadern, Germany
b Department of Neurology, University of Munich, Klinikum Grosshadern, Germany
c Department of Neuroradiology, University of Aachen, Germany
d Department of Neuroradiology, Alfried-Krupp Hospital Essen, Germany
e Department of Neurology, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
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Fig. 1. Case of a 30-year-old woman comatous for 2 hours upon arrival at the hospital and during the angiography.
A, The anteroposterior view of the angiogram demonstrates the complete caudal occlusion of the BA. A microcatheter was placed in both VAS, and 140 mg of rtPA was administered.
B, An interim result showing partial recanalization.
C, The final result showing complete recanalization of the vertebrobasilar system. The patient was asymptomatic at first but developed a palsy of the right VI and VII cranial nerves 1 day later.
D, Follow-up MR imaging (T1-weighted, contrast-enhanced) confirms the subacute ischemic infarction in the right PICA territory and at the pontomedullary junction, where the nuclei of the VI and VII cranial nerves are located.
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