Author/Editor		Tetičkovič, Erih; Menih, Marija
Title		Trombolitično zdravljenje in dramatično izboljšanje klinične slike pri bolniku z akutno zaporo srednje možganske arterije, spremljano s transkranialno Dopplerjevo sonografijo
Translated title		Thrombolytic treatment and dramatic improvement of the clinical picture in a patient with acute occlusion of the middle cerebral artery followed by transcranial Doppler sonography
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 4
Publication year		2004
Volume		str. 235-8
Language		slo
Abstract		Background. Thrombolytic treatment of ischemic cerebral stroke by means of a recombinant tissue plasminogen activator can be very successful in selected patients. Transcranial Doppler sonography allows us to establish a total occlusion of the middle cerebral artery and to follow continuously the process of recanalization during and immediately after thrombolysis. Patient and methods. 62-year-old male patient with acute occlusion of the middle cerebral, artery at its bifurcation resulting in left-side hemiplegia and left-side sensibility disorders is presented The process of recanalization was followed by means of transcranial Doppler sonography. Five minutes after the termination of thrombolysis complete recanalization resulted in a dramatic improvement of the neurological clinical picture. After several days of hospitalization the neurologically intact patient was discharged from hospital. Conclusions. In patients with ischemic cerebral stroke the mechanism of dramatic clinical improvement following thrombolytic treatment is associated with complete recanalization of the vascular occlusion which can be objectivized by transcranial Doppler sonography.
Summary		Izhodišča. Trombolitično zdravljenje ishemične možganske kapi z rekombinantnim tkivnim aktivatorjem plazminogena je pri izbranih bolnikih zelo uspešno. S transkranialno Dopplerjevo sonografijo lahko ugotovimo popolno zaporo srednje možganske arterije in kontinuirano spremljamo proces rekanalizacije med in neposredno po trombolizi. Bolnik in metode. Predstavljen je 62-letni bolnik z akutno zaporo srednje možganske arterije v njenem odcepišču s posledično levostransko hemiplegijo in senzibilitetnimi motnjami po hemitipu levo. S transkranialno Dopplerjevo sonografijo smo spremljali proces rekanalizacije. Pet minut po končani trombolizi je prišlo ob popolni rekanalizaciji arterije do dramatičnega izboljšanja nevrološke klinične slike. Po nekajdnevni hospitalizaciji je bil bolnik odpuščen v domačo nego nevrološko povsem brezhiben. Zaključki. Mehanizem dramatičnega izboljšanja pri bolnikih z ishemično možgansko kapjo je pri trombolitičnem zdravljenju povezan s kompletno rekanalizacijo žilne zapore, ki jo je moč objektivizirati s transkranialno Dopplerjevo sonografijo.
Descriptors		CEREBRAL INFARCTION CEREBRAL EMBOLISM AND THROMBOSIS THROMBOLYTIC THERAPY ALTEPLASE MIDDLE AGE HEMIPLEGIA ULTRASONOGRAPHY, DOPPLER TOMOGRAPHY, X-RAY COMPUTED