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Trombektomi gav gott resultat vid basilaris­trombos: Förlängt tidsfönster för ingreppet föreslås
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Norrlands universitetssjukhus, Umeå.
Avdelningen för diagnostisk radiologi, Norrlands universitetssjukhus, Umeå.
2014 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 27-28, 1188-1190 p.Article in journal (Refereed) Published
Abstract [sv]

Basilaristrombos är ett akut och livshotande tillstånd. Intravenös trombolys är förstahandsbehandling, men ibland kan det vara en fördel att kombinera eller ersätta behandlingen med trombektomi. 

Lyckade behandlingsresultat med trombektomi finns beskrivna ända upp till 12–24 timmar efter insjuknandet. 

I fallbeskrivningarna diskuteras basilaristrombos hos två patienter som insjuknat med oklar medvetandesänkning. 

DT-angiografi gav diagnosen, och trombektomi kunde utföras 10 respektive 13 timmar efter insjuknandet. Långtidsresultatet var gott. 

Slutsatsen är att DT alltid ska kompletteras med DT-angiografi vid utredning av en akut medvetandepåverkad patient. 

Trombektomi bör övervägas om basilaristrombos påvisas.

Abstract [en]

[Thrombectomy gave good results in basilar thrombosis. Prolonged time window for the intervention is proposed].

Basilar stroke is one of the most devastating acute cerebral vascular events. Intravascular thrombectomy may be performed beyond the 4.5 hours intravenous thrombolysis time window. However, the time window for thrombectomy in basilar stroke remains unclear. In our clinics, two cases of coma of unknown origin were diagnosed through CT angiography as distal basilar occlusion and treated with thromb­ectomy. Recanalization was achieved at 10 hours after stroke onset in case 1 and at 13 hours in case 2. The first patient regained consciousness shortly after operation and walked unlimited at 2 months after stroke. The second patient woke up slowly with cortical blindness, cerebellar ataxia, and unilateral weakness. At 10 months post stroke, he moved unlimited with mRS 2. Therefore, acute brain CT scan should always be accompanied with CT angiography in cases of coma of unknown origin for the differential diagnosis of basilar stroke where thrombectomy may be considered up to 13 hours after stroke onset.

Place, publisher, year, edition, pages
Läkartidningen förlag AB , 2014. Vol. 111, no 27-28, 1188-1190 p.
National Category
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-98389PubMedID: 25162109OAI: oai:DiVA.org:umu-98389DiVA: diva2:782515
Available from: 2015-01-21 Created: 2015-01-21 Last updated: 2017-12-05Bibliographically approved

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PubMedhttp://www.lakartidningen.se/Klinik-och-vetenskap/Fallbeskrivning/2014/07/Trombektomi-gav-gott-resultat-vid-basilaristrombos/#eng

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Gu, Weigang

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