• ULTRASOUND-ENHANCED SYSTEMIC THROMBOLYSIS FOR ACUTE ISCHEMIC STROKE

    M. De Lima Oliveira, R. Nogueira, K. Andrade Norremose, A. Maria Negrao Esteves, F. Iuji Yamamoto, E. Faria Evaristo, M. Jacobsen Teixeira, E. Bor-Seng-Shu
    Department of Neurology, University Hospital, University of São Paulo – São Paulo, Brazil

    Objective: It is supposed that Transcranial Doppler ultrasonography (TCD) during thrombolysis may help to expose thrombi to tissue plasminogen acPvator (t-PA). The aim of this study is to determine if TCD can safely enhance the thrombolyPc acPvity of t-PA.

    Material and Methods: Patients with acute ischemic stroke which fufill current criteria to intravenous t-PA treatment were randomly assigned to receive continuous 2 MHz TCD (the target group) or placebo (the control group). In follow up analysis, outcomes are defined as good (as indicated by a score of 0 to 2 on the modified Rankin scale) or favorable (scores of 0 to 1 on modified Rankin Scale).

  • DISSECTION OF CAROTID ARTERY. A CASE REPORT

    S. Andonova-Atanasova 1, F. Kirov 1, Ch. Bachvarov 2, V. Velinov 2
    1 Department of Neurology, Second Clinic of Neurology,
    2 Department of Radiology, University Hospital St. Marina – Varna, Bulgaria

    Objective: The term dissection refers primarily to an elevation or separation of the intimal lining of an artery from the subjacent media and, less frequently, to separation of the media from the adventitia. Dissection is usually accompanied by hemorrhage into the arterial wall. According to the literature serious vascular injurie to the neck may be asymptomatic or masked by other life-threatening conditions.

    Material and Methods: We observed one patient - 44 years old men, with multiple trauma to the neck and left leg, three months before the hospitalization, suffering from acute ischemic stroke. There were no risk factors for cerebrovascular disease. CT angiography was obtained by Spiral Scanner with reconstructions and interpretation by a radiologist. Color-coded duplex sonography was used to determine the extracranial blood flow velocity and the wall of carotid arteries.

  • EARLY HEMODYNAMIC CHANGES POST INTRACRANIAL THROMBECTOMY: A SIGN OF VESSEL WALL INJURY?

    I. M. Pignat 1, V. Mendes Pereira 2, F. Perren 1
    1 HUG, University Hospital and Medical Faculty of Geneva, Department of Neurology, Neurosonology Unit – Geneva,
    2 HUG, University Hospital and Medical Faculty of Geneva, Department of Radiology, Interventional Neuroradiology Unit – Geneva, Switzerland

    Objective: Stent retrievers are new devices that can be also used to perform mechanical intracranial thrombectomy. They have revolutionized endovascular treatment of acute ischemic stroke with good recanalization and acceptable safety. However, previous animal studies have shown that mechanical thrombectomy may cause endothelial injury of the arterial wall leading to myointimal hyperplasia.

    Material and Methods: Acute ischemic stroke patients suffering from acute intracranial single large artery occlusion in which mechanical thrombectomy using stent retrievers was performed were studied. Only those with complete vessel recanalization as assessed by post-procedural DSA and in whom MRA and transcranial duplex sonography (TDS) were performed were retained. Complete revascularization was defined as modified TICI 2b or 3. Patients treated with intra-arterial thrombolysis or stenting of these arteries were excluded.