Thrombolytic therapy for acute stroke in late pregnancy with intra-arterial recombinant tissue plasminogen activator.

David M. Johnson, David C. Kramer, Ezra Cohen, Meredith Rochon, Mara Rosner, Jesse Weinberger

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: The most common presentation of ischemic stroke related to pregnancy is arterial occlusion, occurring during the third trimester or postpartum. The authors present the first successful administration of intra-arterial cerebral tissue plasminogen activator to treat an embolic cerebral vascular accident in a 37-week parturient resulting in complete recovery of neurological function. METHODS: The patient presented with left hemiplegia, left-sided neglect, and aphasia. Right internal carotid artery cerebral angiogram showed occlusion of the mid-M1 segment of the middle cerebral artery (MCA). After 15 mg of tissue plasminogen activator was administered via intra-arterial route, there was greatly improved retrograde flow through the posterior communication artery and the MCA territory. RESULTS: A reduction in size of the MCA occlusion was noted with improvement of antegrade flow through the MCA. Three days after the procedure, the patient was induced successfully and delivered a healthy infant vaginally. CONCLUSIONS: This report describes the use of intra-arterial tissue plasminogen activator in the setting of stroke in late pregnancy.

Original languageEnglish (US)
JournalStroke
Volume36
Issue number6
StatePublished - 2005
Externally publishedYes

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Thrombolytic Therapy
Middle Cerebral Artery
Tissue Plasminogen Activator
Stroke
Pregnancy
Hemiplegia
Middle Cerebral Artery Infarction
Aphasia
Recovery of Function
Third Pregnancy Trimester
Internal Carotid Artery
Postpartum Period
Accidents
Blood Vessels
Angiography
Arteries
Communication
Parturition

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Thrombolytic therapy for acute stroke in late pregnancy with intra-arterial recombinant tissue plasminogen activator. / Johnson, David M.; Kramer, David C.; Cohen, Ezra; Rochon, Meredith; Rosner, Mara; Weinberger, Jesse.

In: Stroke, Vol. 36, No. 6, 2005.

Research output: Contribution to journalArticle

Johnson, David M. ; Kramer, David C. ; Cohen, Ezra ; Rochon, Meredith ; Rosner, Mara ; Weinberger, Jesse. / Thrombolytic therapy for acute stroke in late pregnancy with intra-arterial recombinant tissue plasminogen activator. In: Stroke. 2005 ; Vol. 36, No. 6.
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AU - Weinberger, Jesse

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