[Repeated treatment of subtotal vertebrobasilar stenosis with tissue plasminogen activator (tPA)]

Nervenarzt. 1992 Dec;63(12):755-60.
[Article in German]


We report on the successful repeated treatment of a patient with rapidly progressive severe brain-stem stroke by application of I.V. tissue plasminogen activator (tPA). This treatment twice led to a prompt remission of severe brain-stem symptoms, although a permanent therapeutic success could not be achieved. Unfortunately, the patient died a few days later from pneumonia and sepsis. Necropsy revealed bilateral partial brain-stem infarctions and a subtotal stenosis of the vertebrobasilar junction with superimposed fresh thrombus. The clinically dramatic response to tPA indicates that this type of treatment is potentially successful in high-grade subtotal basal cerebral artery stenosis with progressive stroke symptoms. In particular, application of tPA should be considered if stroke progression cannot stopped by therapeutic heprinization. A prospective randomized oligocentric study is advocated.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Basilar Artery / pathology
  • Brain Stem / blood supply*
  • Brain Stem / pathology
  • Cerebral Angiography
  • Cerebral Infarction / pathology
  • Cerebral Infarction / therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neurologic Examination / drug effects
  • Recurrence
  • Tissue Plasminogen Activator / administration & dosage*
  • Vertebral Artery / pathology
  • Vertebrobasilar Insufficiency / pathology
  • Vertebrobasilar Insufficiency / therapy*


  • Tissue Plasminogen Activator