Good Times - Bad Times: My Story regarding Acute Stroke Treatment

In precomputerized tomography (CT) times, several attempts had been made to use thrombolysis in stroke patients. In most cases these were very late, desperate attempts in severely affected patients, in whom it was unclear whether the patient had ischemic or hemorrhagic stroke. Many patients died, and upon autopsy, massive hemorrhages were found and thrombolysis was thereafter abandoned. Modern thrombolysis in the imaging age started with a series of young basilar artery thrombosis patients admitted to our ICU, who all died. We were very much moved by these tragedies. Hermann Zeumer, who had introduced transfemoral cerebral angiography into our neuroradiology services, contacted our cardiologists (who were using intracoronary streptokinase) and borrowed some wires and catheters. The next patient came: a young lady who had her basilar occlusion during exercise (now we know it was a spontaneous vertebral dissecIntroduction