Abstract
Dramatic improvement of clinical symptoms and signs is not infrequent in patients with acute ischemic stroke. Such a syndrome has been called the “spectacular shrinking deficit,” and its mechanism is presumed to be the rapid migration of an embolus to the distal branches of a cerebral artery after initially lodging in the main trunk [6, 7]. Supporting evidence for the mechanism and the frequency of this phenomenon has recently been reported by Minematsu and coworkers [5]. The existence of such patients encouraged us to carry out a clinical trial of thrombolytic therapy in acute ischemic stroke prior to the appearance of ischemic findings on computed tomography (CT).
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References
Adams RJ, Meador KJ, Sethi KD, Grotta JC, Thompson DS (1987) Graded neurological scale for use in acute hemispheric stroke treatment protocols. Stroke 18:665–669
Brott TG, Haley EC, Levy DE, et al (1992) Urgent therapy for stroke. Part I. Pilot study of tissue plaminogen activator administered within 90 minutes. Stroke 23:632–640
Cerebral Embolism Task Force (1989) Cardiogenic brain embolism. Arch Neurol 46:727–743
Hacke W, Zeumer H, Ferbert A, Bruckmann H, del Zoppo GJ (1988) Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 19:1216–1222
Minematsu K, Yamaguchi T, Omae T (1992) Spectacular shrinking deficit: Rapid recovery from a major hemispheric syndrome by migration of an embolus. Neurology 42:157–162
Mohr JP, Barnett HJM (1986) Classification of ischemic strokes. In: Barnett HJM, Stein BM, Mohr JP, Yatsu FM (eds) Stroke: Pathophysiology, diagnosis and management, Volume 1. Churchill Livingstone, New York, p 281
Mohr JP, Gautier JC, Hier DB, Stein BM (1986) Middle cerebral artery. In: Barnett HJM, Stein BM, Mohr JP, Yatsu FM (eds) Stroke: Pathophysiology, diagnosis and management, Volume 1. Churchill Livingstone, New York, p 377
Mori E, Tabuchi M, Yoshida T, Yamadori A (1988) Intracarotid urokinase with thromboembolic occlusion of the middle cerebral artery. Stroke 19:802–812
Mori E, Yoneda Y, Tabuchi M, et al (1992) Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology 42:976–982
von Kummer R, Hacke W (1992) Safety and efficacy of intravenous tissue plasminogen activator and heparin in acute middle cerebral artery. Stroke 23:646–652
Yamaguchi T, Hayakawa T, Kikuchi H, Abe T (1991) Thrombolytic therapy in embolic and thrombotic cerebral infarction: A cooperative study. In: Hacke W, del Zoppo GJ, Hirschberg M (eds) Thrombolytic therapy in acute ischemic stroke. Springer-Verlag, Berlin Heidelberg New York, p 168
Yamaguchi T, Minematsu K, Choki J, Ikeda M (1984) Clinical and neuroradiological analysis of thrombotic and embolic cerebral infarction. Jpn Circ J 48:50–58
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© 1993 Springer-Verlag Berlin Heidelberg
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Yamaguchi, T., Hayakawa, T., Kikuchi, H. (1993). Intravenous Tissue Plasminogen Activator in Acute Thromboembolic Stroke: A Placebo-Controlled, Double-Blind Trial. In: del Zoppo, G.J., Mori, E., Hacke, W. (eds) Thrombolytic Therapy in Acute Ischemic Stroke II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78061-5_9
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DOI: https://doi.org/10.1007/978-3-642-78061-5_9
Publisher Name: Springer, Berlin, Heidelberg
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