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Initial CT showed a large parenchymal hypodensity in 11(34%)patients,a small hypodensity in 15(47%)patients,and no hypodensity in 6(19%)patients. Recanalization after thrombolytic therapy was observed in 4 patients(12.5% in each treatment group).Follow-up CT showed six hemorrhagic infarcts and four parenchymal hematomas unrelated to recanalization,alteplase,or urokinase administration,but commonly associated with intraarterial treatment.Clinical outcome was fatal in 53%,poor in 31%,and moderate or good in 16%of the patients.Outcome was equal in different treatment groups and closely linked to both the quality of leptomeningeal collaterals and the extent of parenchymal hypodensity on the first CT.Because intravenous or intraarterial treatment with alteplase or urokinase fails to recanalize the vascular obstruction,it does not improve the prognosis of intracranial internal carotid artery occlusion over that of the natural course.Improved results may be possible with novel recanalization techniques. |
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carotid artery occlusion,intracranial
cerebrovascular accident
cerebrovascular accident,acute management of
cerebrovascular accident,thrombolytic agents in treatment
fibrinolytic agents
fibrinolytic agents,intra-arterial local infusion
internal carotid artery
neuroradiology,interventional
prognosis
recanalization,arterial
tissue plasminogen activator,intravenous
treatment of neurologic disorder
urokinase
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