Acute ischemic myelopathy treated with intravenous thrombolysis: Four new cases and literature review.

Détails

ID Serval
serval:BIB_35D735B97FFD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Acute ischemic myelopathy treated with intravenous thrombolysis: Four new cases and literature review.
Périodique
International journal of stroke
Auteur(s)
Jankovic J., Rey Bataillard V., Mercier N., Bonvin C., Michel P.
ISSN
1747-4949 (Electronic)
ISSN-L
1747-4930
Statut éditorial
Publié
Date de publication
12/2019
Peer-reviewed
Oui
Volume
14
Numéro
9
Pages
893-897
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article ; Review
Publication Status: ppublish
Résumé
Intravenous thrombolysis is a well-established treatment of ischemic stroke within 4.5 h. However, its effectiveness in acute ischemic myelopathy is unknown.
We describe a series of four acute ischemic myelopathy patients treated with intravenous thrombolysis within 4.5 h and review the current literature to explore this treatment feasibility, potential safety, and efficacy.
We reviewed all routinely collected clinical, radiological, and follow-up data of patients with a final acute ischemic myelopathy diagnosis who received acute intravenous thrombolysis in our stroke network. We also reviewed thrombolyzed acute ischemic myelopathy patients in the literature.
Four patients (three women) aged 57 to 83 years presented with acute uni- or bilateral extremity paresis, considered initially as cerebral strokes in two of them. After excluding contraindications by brain imaging in three, spinal computed tomography in one and confirmation of acute ischemic myelopathy on spinal magnetic resonance imaging in one patient, intravenous thrombolysis was administered at 135, 190, 240, and 245 min accordingly. Subacute diffusion-weighted imaging-magnetic resonance imaging confirmed acute ischemic myelopathy in all but one patient. Favorable outcome was achieved in two patients rapidly and in three patients at three-month follow-up. We identified seven other thrombolyzed acute ischemic myelopathy patients in the literature, who showed variable recovery and no hemorrhagic complications.
With appropriate acute imaging, intravenous thrombolysis after acute ischemic myelopathy is feasible and potentially safe within 4.5 h. Given the potential of benefit of thrombolysis in acute ischemic myelopathy, this treatment warrants further efficacy and safety studies.
Mots-clé
Aged, Aged, 80 and over, Diffusion Magnetic Resonance Imaging, Female, Fibrinolytic Agents/therapeutic use, Humans, Male, Middle Aged, Spinal Cord Ischemia/diagnostic imaging, Spinal Cord Ischemia/drug therapy, Thrombolytic Therapy/methods, Time-to-Treatment, Tissue Plasminogen Activator/therapeutic use, Treatment Outcome, Spinal cord ischemia, ischemic myelopathy, thrombolysis
Pubmed
Web of science
Création de la notice
26/05/2019 15:07
Dernière modification de la notice
20/06/2020 6:18
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