抗凝、诱导性高血压及静脉注射组织型纤溶酶原激活剂使闭锁综合征逆转。
Reversal of locked-in syndrome with anticoagulation, induced hypertension, and intravenous t-PA.
作者信息
Janjua Nazli, Wartenberg Katja E, Meyers Philip M, Mayer Stephan A
机构信息
The Neurological Intensive Care Unit, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
出版信息
Neurocrit Care. 2005;2(3):296-9. doi: 10.1385/NCC:2:3:296.
INTRODUCTION
Widespread use of intravenous tissue plasminogen activator (t-PA) for acute ischemic stroke is limited by multiple contraindications to its use.
CASE REPORT
This article describes a patient with stuttering symptoms of pontine ischemia caused by vertebrobasilar dissection who suddenly deteriorated into a locked-in state 32 hours after symptom onset. The quadriparesis was successfully reversed within 3 hours of onset with the combination of pharmacologically induced hypertension, anticoagulation, and intravenous t-PA.
DISCUSSION
Even in the face of numerous contraindications (including hypertension, anticoagulation, and treatment beyond 3 hours of symptom onset), intravenous t-PA can be used successfully in carefully selected cases.
引言
静脉注射组织型纤溶酶原激活剂（t-PA）在急性缺血性卒中的广泛应用受到其多种使用禁忌的限制。
病例报告
本文描述了一名因椎基底动脉夹层导致脑桥缺血出现口吃样症状的患者，其症状发作32小时后突然恶化为闭锁状态。通过药物诱导高血压、抗凝和静脉注射t-PA联合治疗，在发病3小时内成功逆转了四肢瘫痪。
讨论
即使面对众多禁忌（包括高血压、抗凝以及症状发作超过3小时后治疗），静脉注射t-PA在精心挑选的病例中仍可成功使用。
Zotero 插件