Intravenous thrombolisys in basilar dissection: report of a good recovery and follow-up

Abstract

A 33 year-old man arrived after 3h with dysarthria and right-sided hemiparesis (National Institutes Health Stroke Scale (NIHSS:11)). We perform IV thrombolysis and after 1h, NIHSS: 4. After 24h, he presented fluctuating neurological symptoms. Angiography and CT-angio (CTA) (Figures A and B) demonstrated an isolated dissection of the basilar artery, without subarachnoid hemorrhage. Anticoagulation was ini tiated with rapid improvement. After 7 days he was discharged with NIHSS: 2, Rankin: 2. CTA (Figure C) showed partial basilar recanalization, and after 6 months (Figure D) the basilar artery was normal. Although not considered a formal therapeutic option for arterial dissection 1-3 , IV thrombolysis was performed and maybe prevented microembolic events, improving prognosis 4,5 .