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颅内动脉夹层相关缺血性卒中静脉溶栓的安全性及预后

Safety and outcome of intravenous thrombolysis in ischemic stroke related to intracranial artery dissection.

作者信息

Yang Wen, Wang Jian-Wei, Zhang Mei-Xia, Chen Hong-Fang

机构信息

Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine(formerly Jinhua Municipal Central Hospital), No.365 Renmin East Road, Jinhua, 321000, Zhejiang Province, China.

出版信息

BMC Neurol. 2025 Sep 2;25(1):376. doi: 10.1186/s12883-025-04383-2.

Abstract

BACKGROUND

The clinical efficacy of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) associated with intracranial artery dissection (IAD) remains uncertain. This study presents a case of basilar artery dissection (BAD) in a 57-year-old Asian female patient devoid of previous risk factors for stroke who experienced a sudden onset of consciousness disturbance. The patient's clinical condition deteriorated during IVT administration, but subsequent medical intervention and rehabilitative exercises facilitated eventual recovery of daily functioning. MRI eventually identified the etiology of the patient's AIS.

CONCLUSION

AIS related to anterior circulation IAD may pose a relatively high risk of hemorrhagic transformation and symptom exacerbation during the early stages of IVT, but the impact on long-term prognosis remains uncertain. Consequently, further investigation is warranted to assess the safety and efficacy of IVT in such patients.

摘要

背景

静脉溶栓(IVT)治疗与颅内动脉夹层(IAD)相关的急性缺血性卒中(AIS)的临床疗效仍不确定。本研究报告了一例57岁亚洲女性基底动脉夹层(BAD)病例,该患者既往无卒中危险因素,突发意识障碍。患者在静脉溶栓治疗期间临床状况恶化,但随后的医学干预和康复锻炼促进了日常功能的最终恢复。MRI最终确定了患者急性缺血性卒中的病因。

结论

与前循环颅内动脉夹层相关的急性缺血性卒中在静脉溶栓早期可能有较高的出血转化和症状加重风险,但对长期预后的影响仍不确定。因此,有必要进一步研究评估静脉溶栓在此类患者中的安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3e/12406453/370afca04aee/12883_2025_4383_Fig1_HTML.jpg

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