Literature Review and Case Report of Intravenous Thrombolysis in Acute Cerebral Infarction Attributed to Cervical Arterial Dissection.

ABSTRACT

Acute cerebral infarction (ACI) caused by cervical arterial dissection (CAD) is a rare clinical disease. Therapeutic approaches include anticoagulant therapy, antiplatelet aggregation, and thrombolytic therapy. Currently, anticoagulant therapy or antiplatelet aggregation is the primary choice, whereas the thrombolytic therapy is still controversial. In this article, we report a patient with ACI caused by right CAD, which led to a compensatory increase in blood supply to the right middle cerebral artery through the anterior communicating artery. After treatment with intravenous thrombolysis, the clinical symptoms of the patient improved, and the National Institutes of Health Stroke Scale (NIHSS) score declined to 2 points from the initial 14 points. In addition, cranial computed tomography scans showed that there were no signs of intracranial or extracranial hemorrhage, but that the vessel occlusion was still uncured. After 17 days of antiplatelet aggregation treatment, a cranial magnetic resonance angiography scan showed complete recanalization of the right internal carotid artery. Furthermore, the NIHSS score was reduced to 1 point when the patient discharged, and for 3 months of follow-up.