Černík David, Ospalík Dušan, Šaňák Daniel, Cihlář Filip
Department of Neurology, Comprehensive Stroke Center, Masaryk Hospital Ústí nad Labem, KZ a.s., Ústí nad Labem, Czechia.
Department of Neurology, Comprehensive Stroke Center, Palacký University Medical, School and Hospital, Olomouc, Czechia.
Case Rep Neurol. 2021 Jul 29;13(2):510-514. doi: 10.1159/000518193. eCollection 2021 May-Aug.
Acute ischemic vertebrobasilar stroke (AIVBS) is usually associated with poor outcome and prognosis and in case of basilar artery occlusion (BAO) with high mortality. Intravenous thrombolysis (IVT), as a standard recanalization therapy of acute ischemic stroke (IS) within first 4.5 h, can be administrated beyond this therapeutic time window in case of symptomatic BAO. Repeated IVT is generally contraindicated in case of early recurrent IS, despite a risk of poor outcome or death after recurrent IS. The aim was to present 2 cases of repeated IVT for recurrent AIVBS and discuss specific situations where repeated IVT may be considered. Up to now, repeated IVT has been reported only in recurrent stroke in anterior circulation.
急性缺血性椎基底动脉卒中（AIVBS）通常预后不良，若发生基底动脉闭塞（BAO），死亡率很高。静脉溶栓（IVT）作为急性缺血性卒中（IS）发病4.5小时内的标准再通治疗方法，对于有症状的BAO患者，可在该治疗时间窗之外进行。尽管早期复发性IS有预后不良或死亡风险，但一般情况下，早期复发性IS患者禁忌重复IVT。本文旨在介绍2例复发性AIVBS患者重复IVT的病例，并讨论可考虑重复IVT的特殊情况。到目前为止，仅在前循环复发性卒中中报道过重复IVT。
