Posterior circulation stroke: treatment

Evidence-based neurology checklist on posterior circulation stroke: treatment: Intravenous thrombolysis Intravenous thrombolysis is the first treatment option It is beneficial up to 8 hours after onset The benefit is enhanced by concomitant ultrasound and microbubbles Earlier recanalization is the…

Intravenous thrombolysis

  • Intravenous thrombolysis is the first treatment option
  • It is beneficial up to 8 hours after onset
  • The benefit is enhanced by concomitant ultrasound and microbubbles
  • Earlier recanalization is the best predictor of outcome
  • Mortality is predicted by older age and associated intracerebral haemorrhage (ICH)

Intra-arterial thrombolysis

Mechanical thrombectomy

Other treatments

References

  1. Pagola J, Ribo M, Alvarez-Sabin J, Lange M, Rubiera M, Molina CA. Timing of recanalization after microbubble-enhanced intravenous thrombolysis in basilar artery occlusion. Stroke 2007; 38:2931-2934.
  2. Tsao JW, Hemphill JC, Johnston C, Smith WS, Bonovich DC. Initial Glasgow Coma Scale score predicts outcome following thrombolysis for posterior circulation stroke. Arch Neurol 2005; 62:1126-1129.
  3. Sairanen T, Strbian D, Soinne L, et al. Intravenous thrombolysis of basilar artery occlusion: predictors of recanalization and outcome. Stroke 2011; 42:2175-2179.
  4. Lindsberg PJ, Mattle HP. Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 2006; 37:922-928. 
  5. Powers WJ, Derdeyn CP, Biller J, et al; American Heart Association Stroke Council. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015; 46:3020-3035.
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