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VERTEBRAL ARTER DİSEKSİYONLU BİR İNME OLGUSUNDA İNTRA-ARTERYAL TROMBOLİTİK TEDAVİ

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
The importance of dissections in young stroke patients have been emphasized currently. Carotis artery dissections are more frequent than the vertebral artery. The clinical picture of vertebro-basilar artery dissections is one of an occlusion of intracranial arteries. In this article, the clinical features and evaluation of a young stroke patient due to vertebral artery dissection and the value of intra-arterial thrombolytic therapy has been debated. Observation.- Forty-two years old male patient was brought to emergency room. The patient had clinical features of a sudden onset brain stem dysfunction. An early CT scan revealed a hyperdensity over the basilar artery suggestive of a basilar artery trombosis. In order to find out the etiology and to treat this young onset stroke patient, an angiography was performed revealing a vertebral artery dissection and a basilar artery trombosis secondary to this dissection. Three hours after the insult, he was treated with intra-arterial urokinase. An early recovery was observed.
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Abstract (Original Language): 
Genç yaş serebro-vasküler olaylarında diseksiyonların etyolojideki yeri giderek daha önem kazanmaktadır. Daha ziyade karotis sistemine ait görülen diseksiyonlar vertebral arterde seyrektir. Bu yazıda vertebral arter diseksiyonu gelişmiş serebro-vasküler olaylı bir hastanın klinik öyküsü, tanıya gidişteki aşamalar ve erken intra-arteryal trombolitik tedavinin uygulamadaki yerinin vurgulanması amaçlanmıştır. Kırkiki yaşında bir erkek hasta ani olarak gelişen inme ile acil ünitemize getirilmiş ve yapılan kranyal BT tetkikinde baziler arter trombozu varlığından şüphe edilmiştir. Klinik özellikleri ile beyin sapı yetersizliğini düşündüren hastaya tanı ve gerekirse tedavi amacıyla anjiyografi yapılmış ve hastada vertebral arter diseksiyonu ve buna sekonder baziler arter trombozu saptanmıştır. Klinik bulguların başlangıcından üç saat sonra baziler arter trombozu intra-arteryal ürokinaz yardımı ile endovasküler olarak rekanalize edilebilmiştir. Hastada hızlı bir düzelme izlenmiştir.
FULL TEXT (PDF): 
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  • 4
281-285
  • Turkish

REFERENCES

References: 

1. Hart RG. Vertebral artery dissection. Neurology (NY) 1988; 38: 987.
2. Chapleeou CE, Robetrtson JT. Spontaneous cevrvical carotid artery dissection:outpatient treatment with continuous heparin infusion using a totally implantable infusion device. Neurosurgery 1981; 8: 83.
3. Fisher CM, Ojemann RG, Roberson GH. Spontaneous carotid dissection. Headache 1982; 22: 60.
4. Mc Neill DH Jr, Dreisback J, Marsden RJ. Spontaneous dissection of the internal carotid artery: Its conservation management with heparin sodium. Arch Neurol 1980; 37: 54.
5. Saver JL, Easton JD, Hart RG. Dissections and trauma of cervicocerebral arteries. Stroke. Ed. Barnett HJM, Mohr JP, Stein BM, Yatsu FM. Second edition. New York, 1992; 671-688.
6. Biller J, Hingten LW, Adams PH. Cervicocephalic arterial dissections: a ten year experience. Arch Neurol 1986; 43: 1234-1238.
7. Arunodaya GR, Vani S, Shankar SK et al. Fibromuscular dysplasia with dissection of basilar artery presenting as locked-in syndrome. Neurology 1997; 48: 1605-1608.
8. De Bray JM, Penisson B, Dubas F. Extracranial and intracranial vertebrobasilar dissections. J Neurol Neurosurg Psychiatry 1997;63: 46-51.
9. Tekin S, Bingöl CA, Aktan S. Gençlerde inme nedeni olarak servikosefalik arter diseksiyonu. Beyin Damar Hastalıkları Dergisi 1996; 2: 55-61.
10. Zuber M, Meory E, Meder JF. Magnetic resonance imaging and dynamic CT scan in cervical artery dissections. Stroke 1994; 25: 576-581.
11. Archer C, Horenstein S. Basilar artery occlusion: Clinical and radiological correlation. Stroke 1997; 8: 383-390
12. Caplan L. Occlusion of the vertebral or basilar artery.Stroke 1979;10: 277-282.
13. Grond M, Stenzel C, Schmülling S et al. Early intravenous thrombolysis for acute ischemic stroke in a community-based approach. Stroke 1998; 29: 1544- 1549.
14. Gönner F, Remondo L, Mattle H et al. Local intra-arterial thrombolysis in acute ischemic stroke. Stroke 1998; 9: 1894-1900.

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