Journal ArticleDOI
Basilar artery occlusion
Reads0
Chats0
TLDR
If BAO is recognised early and confirmed with multimodal CT or MRI, intravenous thrombolysis or endovascular treatment can be undertaken, however, the best treatment approach to improve clinical outcome still needs to be ascertained.Abstract:
The clinical presentation of basilar artery occlusion (BAO) ranges from mild transient symptoms to devastating strokes with high fatality and morbidity. Often, non-specific prodromal symptoms such as vertigo or headaches are indicative of BAO, and are followed by the hallmarks of BAO, including decreased consciousness, quadriparesis, pupillary and oculomotor abnormalities, dysarthria, and dysphagia. When clinical findings suggest an acute brainstem disorder, BAO has to be confirmed or ruled out as a matter of urgency. If BAO is recognised early and confirmed with multimodal CT or MRI, intravenous thrombolysis or endovascular treatment can be undertaken. The goal of thrombolysis is to restore blood flow in the occluded artery and salvage brain tissue; however, the best treatment approach to improve clinical outcome still needs to be ascertained.read more
Citations
More filters
Journal ArticleDOI
Basilar Artery Thrombosis in a Child Treated With Intravenous Tissue Plasminogen Activator and Endovascular Mechanical Thrombectomy
Jakob Fink,Laura Sonnenborg,Line Lunde Larsen,Alfred Peter Born,Markus Holtmannspötter,Daniel Kondziella +5 more
TL;DR: To the authors’ knowledge this is the first report on basilar artery occlusion in a child treated with “bridging” therapy, the combination of intravenous thrombolysis and endovascular thrombectomy, and the patient made a full clinical recovery.
Journal ArticleDOI
Intravenous thrombolysis is more safe and effective for posterior circulation stroke: Data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China).
Xu Tong,Xiaoling Liao,Yuesong Pan,Yibin Cao,Chunjuan Wang,Liping Liu,Huaguang Zheng,Xingquan Zhao,Chunxue Wang,Yilong Wang,Yongjun Wang +10 more
TL;DR: This study suggests that IVT with alteplase is more safe and effective for PCS, although more PCS patients seemed to die within 90 days than did ACS patients, and there was no significant difference in the occurrence of mortality.
Journal ArticleDOI
Current treatment of basilar artery occlusion
TL;DR: “Bridging” protocols have been introduced where rescue therapies such as endovascular thrombolysis and on‐demand mechanical thrombectomy or angioplasty are used andMultimodal imaging techniques should be used to choose the best therapeutic option individually.
Journal ArticleDOI
Firstline a direct aspiration first pass technique versus firstline stent retriever for acute basilar artery occlusion: a systematic review and meta-analysis.
TL;DR: It is suggested that for patients with acute BAO, firstline ADAPT might achieve higher and faster recanalization, comparable neurological improvement and safety compared with firstline SR.
Journal ArticleDOI
Intensive care management of acute ischemic stroke.
TL;DR: This chapter will discuss optimal, pragmatic neurocritical care management of patients with acute ischemic stroke during the "golden" emergency department hours from the perspective of the neurointensivist.
References
More filters
Journal ArticleDOI
Guidelines for management of ischaemic stroke and transient ischaemic attack 2008
Peter A. Ringleb,Marie-Germaine Bousser,Gary A. Ford,Philip M.W. Bath,Michael Brainin,Valeria Caso,Álvaro Cervera,Ángel Chamorro,Charlotte Cordonnier,László Csiba,Antoni Dávalos,Hans-Christoph Diener,José M. Ferro,Werner Hacke,Michael G. Hennerici,Markku Kaste,Peter Langhorne,Kennedy R. Lees,Didier Leys,J. Lodder,Hugh S. Markus,Jean-Louis Mas,Heinrich Mattle,Keith W. Muir,Bo Norrving,Victor Obach,Stefano Paolucci,E. Bernd Ringelstein,Peter D. Schellinger,Juhani Sivenius,Skvortsova Vi,Katharina S. Sunnerhagen,Lars Thomassen,Danilo Toni,Rüdiger von Kummer,Nils Wahlgren,Marion F Walker,Joanna M. Wardlaw +37 more
TL;DR: The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.
Journal ArticleDOI
Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials.
Kennedy R. Lees,Erich Bluhmki,Rüdiger von Kummer,Thomas G. Brott,Danilo Toni,James C. Grotta,Gregory W. Albers,Markku Kaste,John R. Marler,Scott Hamilton,Barbara C. Tilley,Stephen M. Davis,Geoffrey A. Donnan,Werner Hacke +13 more
TL;DR: Patients with ischaemic stroke selected by clinical symptoms and CT benefit from intravenous alteplase when treated up to 4.5 h should be taken to shorten delay in initiation of treatment to increase benefit to a maximum.
Journal ArticleDOI
The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19 435 patients with acute ischaemic stroke
Peter Sandercock,Rory Collins,Carl Counsell,Barbara Farrell,Richard Peto,Jim Slattery,Charles Warlow,S Anderson,A Bowie,J Boyle,A Brownlie,D Charlton,Gina Cranswick,L Day,Martin Dennis,Paul Dorman,H Fraser,M Kaye,Richard I. Lindley,M Liu,C MacDonald,I McCrindle,G Middleton,D. Perry,V Scoltock,Brenda Smith,Hugh R. Taylor,Fiona Waddell,Joanna Wardlaw,J Crowther,J Heineman,S Knight,Andrew Radley,R Ripley,S Richards,S Wilberforce,Zhengming Chen,J vanGijn,Michael R. Harrison,Lars Wilhelmsen +39 more
TL;DR: Aspirinallocated patients had significantly fewer recurrent ischaemic strokes within 14 days with no significant excess of haemorrhagic strokes, so the reduction in death or non-fatal recurrent stroke with aspirin was significant.
Journal ArticleDOI
Mechanical Thrombectomy for Acute Ischemic Stroke: Final Results of the Multi MERCI Trial
Wade S. Smith,Gene Sung,Jeffrey L. Saver,Ronald F. Budzik,Gary Duckwiler,David S Liebeskind,Helmi L. Lutsep,Marilyn M. Rymer,Randall T. Higashida,Sidney Starkman,Y. Pierre Gobin +10 more
TL;DR: Higher rates of recanalization were associated with a newer generation thrombectomy device compared with first-generation devices, but these differences did not achieve statistical significance.
Journal ArticleDOI
The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease.
TL;DR: The results suggest the Penumbra System allows safe and effective revascularization in patients experiencing ischemic stroke secondary to large vessel occlusive disease who present within 8 hours from symptom onset.
Related Papers (5)
Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study (BASICS): a prospective registry study.
Wouter J. Schonewille,Christine A. C. Wijman,Patrik Michel,Christina Rueckert,Christian Weimar,Heinrich Mattle,Stefan T. Engelter,David Tanne,Keith W. Muir,Carlos A. Molina,Vincent Thijs,Heinrich Audebert,Thomas Pfefferkorn,Kristina Szabo,Perttu J. Lindsberg,Gabriel R. de Freitas,L. Jaap Kappelle,Ale Algra +17 more
Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials
Mayank Goyal,Bijoy K Menon,Wim H. van Zwam,Diederik W.J. Dippel,Peter Mitchell,Andrew M. Demchuk,Antoni Dávalos,Charles B. L. M. Majoie,Aad van der Lugt,Maria Angeles De Miquel,Geoffrey A. Donnan,Yvo B.W.E.M. Roos,Alain Bonafe,Reza Jahan,Hans-Christoph Diener,Lucie A. van den Berg,Elad I. Levy,Olvert A. Berkhemer,Vitor Mendes Pereira,Jeremy L. Rempel,Mónica Millán,Stephen M. Davis,Daniel Roy,John Thornton,Luis San Roman,Marc Ribo,Debbie Beumer,Bruce Stouch,Scott Brown,Bruce C.V. Campbell,Robert J. van Oostenbrugge,Jeffrey L. Saver,Michael D. Hill,Tudor G Jovin +33 more