Browsing by Author "Schellinger, Peter D."

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    Complete T2-fogging of pontomedullary infarction in Locked-In Syndrome
    (2008) Nagel, Simon; Herweh, Christian; Bonaut, Aitziber Aleu; Schellinger, Peter D.; Mellado, Patricio
    We report a patient who was treated with intravenous thrombolysis, and subsequently developed a Locked-In Syndrome (LIS). After 2 days, magnetic resonance imaging showed a large bilateral pontomedullary infarction. However, in contrast to the patient's clinical situation, the follow-up T2-weighted MR images up to day 26 did not display the infarction. This phenomenon is known as the so-called fogging effect.
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    Hemorrhagic complications after off-label thrombolysis for ischemic stroke
    (LIPPINCOTT WILLIAMS & WILKINS, 2007) Aleu, Aitziber; Mellado, Patricio; Lichy, Christoph; Koehrmann, Martin; Schellinger, Peter D.
    Background and Purpose-Only 2% to 4% of patients with acute ischemic stroke receive thrombolytic therapy resulting from the current strict inclusion criteria among other issues. Safety of intravenous and intraarterial thrombolysis in off-label situations is controversially discussed. We sought to review the reports on such patients regarding intra- and extracranial hemorrhage. Summary of Review-A MEDLINE search for off-label uses of thrombolysis revealed reports on 273 patients treated with intraarterial or intravenous thrombolysis for ischemic stroke. Symptomatic intracranial hemorrhage occurred in 19 of 273 patients (6.95%) and extracranial hemorrhage in 17 of 273 (6.22%). Conclusions-These data suggest that the overall bleeding risk in off-label thrombolysis may not be as high as presumed. However, the small number of patients in each group and the likely underreporting of worse outcomes preclude drawing any conclusion as to specific treatment recommendations. Selected patients might benefit, however, from thrombolysis in situations not currently considered in the inclusion criteria. To obtain a meaningful database, a registry for off-label thrombolysis should be created. (Stroke. 2007;38:417-422.)