静脉溶栓联合机械取栓成功治疗急性基底动脉闭塞一例报道

Intravenous Thrombolysis Combined with Mechanical Thrombectomy: Report of One Case of Acute Basilar Artery Occlusion

急性基底动脉闭塞致残、致死率极高,临床主要表现为头晕、肢体麻木及活动障碍、严重时迅速出现昏迷。本例患者主因言语不利、左侧肢体活动不利3 h入院。入院时美国国立卫生院神经功能缺损评分为22分,mRS分级为4级,诊断为急性脑梗死,基底动脉主干闭塞。给予阿替普酶静脉溶栓治疗,患者病情曾经一度好转,后再次加重,呈浅昏迷状态,考虑血管再次闭塞,急诊行基底动脉机械取栓术并支架置入术,后续抗血小板、抗凝治疗,痊愈出院。说明早期血管再通是改善预后的关键,溶栓治疗能够提高血管再通率。

Acute basilar artery occlusion （BAO）, having a high rate of disability and mortality, presents clinically with dizziness, numbness of limbs, movement disorder and quick coma when serious. This patient, hospitalized due to disorders of language and left limb movement, NIHSS score being 22, mRS grade being 4 on admission, was diagnosed as acute cerebral infarction, BAO. After alteplase intravenous thrombolysis, the patients＇ condition improved at one time, then aggravated again presenting with light coma and vascular occlusion. After mechanical thrombectomy and stent implantation in emergency, com- bined with antiplatelet and anticoagulant therapies, the patient was discharged. So early revascularization is the key to prognosis improvement and thrombolytie therapy can improve revascularization rates.