If there is ready access to intra-arterial thrombolysis, either in-house or via rapid transfer, a CT angiogram (CTA) should be considered. If a middle cerebral artery occlusion or basilar artery occlusion is noted on CTA and the patient can't be treated with intravenous TPA because of a contraindication, including being outside the time window of 4.5 hours, then intra-arterial thrombolysis is a reasonable option up to about 6 hours after stroke onset.
Source
Oliveira-Filho, J. MD PhD. "Fibrinolytic therapy for acute ischemic stroke" Up to Date. 15 Oct 2008.
Popular Posts
-
Pin worms are a common cause of perianal itching in school age children, age 5-10. Diagnosing this entity can be easy if you look at the an... -
Identify the pathology on this AP and Lateral chest x-ray of a patient who presents with chest pain s/p laprascopic appendectomy. Patient... -
Can you list the predictors of a difficult airway? 1. Difficult Bag-Mask Ventilation Mnemonic = MOANS M ask seal Bushy beards, crust... -
It is often difficult to distinguish but here are some clues ... viral exanthems often have associated fever, malaise, sore throat and conju... -
Yes. There are several case reports. Mechanism Other causes of nonsurgical pneumoperitoneum include pneumothorax, spontaneous bacterial peri... -
The rash: Scroll down for answer * * * * * * HSV-2 sacral radiculitis (Elsberg syndrome). Aside from urinary retention and constipation, ... -
Shoulder dystocia occurs when the anterior shoulder of the infant can't be delivered under the pubic symphysis. Several maneuvers may b... -
Distal radius fractures traditionally require a sugar tong splint to prevent the patient from ranging the wrist and elbow. The sugar tong s... -
A 35 year old man presents with low back pain which radiates down his right leg to the level of the knee. Is this sciatica? Low back pa...
-
This is a question that I’ve gotten a few times over the years. You’ve got a patient in AFIB that has been rate controlled after a bolus of...
