Jafar J J, Tan W S, Crowell R M
Department of Neurosurgery, New York University Medical Center, New York.
J Neurosurg. 1991 May;74(5):808-12. doi: 10.3171/jns.1991.74.5.0808.
A patient harboring a cerebral arteriovenous malformation (AVM) underwent angiography in an attempt to embolize the AVM. During catheterization (and prior to embolization) he became hemiplegic and aphasic. Angiography revealed a complete middle cerebral artery (MCA) occlusion by an embolus. The patient was treated with recombinant tissue plasminogen activator (t-PA), a thrombolytic agent. Restoration of MCA flow was achieved, and the patient recovered. Immediately after MCA embolus, t-PA infusion may lead to thrombolysis and neurological recovery. The decision-making process as well as the risks associated with the use of t-PA are discussed.
一名患有脑动静脉畸形（AVM）的患者接受了血管造影，试图栓塞该AVM。在插管过程中（栓塞前），他出现了偏瘫和失语。血管造影显示大脑中动脉（MCA）被栓子完全阻塞。患者接受了重组组织型纤溶酶原激活剂（t-PA），一种溶栓药物的治疗。MCA血流得以恢复，患者康复。MCA栓子形成后立即输注t-PA可能会导致溶栓和神经功能恢复。本文讨论了决策过程以及使用t-PA相关的风险。
