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Intravenous thrombolysis in ischemic stroke patients with isolated homonymous hemianopia
Author(s) -
Strbian D.,
Soinne L.,
Sairanen T.,
Scheperjans F.,
Salonen O.,
Palomäki M.,
Kaste M.,
Tatlisumak T.
Publication year - 2012
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2012.01646.x
Subject(s) - thrombolysis , medicine , modified rankin scale , stroke (engine) , neuropsychology , neuroimaging , visual field , radiology , hemianopsia , ophthalmology , ischemia , ischemic stroke , psychiatry , myocardial infarction , mechanical engineering , cognition , engineering
Background Patients with posterior ischemic stroke were usually excluded from thrombolytic treatment in clinical trials and clinical practice, and little is known about effectiveness of thrombolysis treatment in such patients who may end up with severe disability. Aims of the study We aimed to describe the outcome of acute ischemic stroke patients presenting with isolated homonymous hemianopia and treated with intravenous thrombolysis. Methods A case report of three patients presenting with homonymous hemianopia owing to posterior circulation stroke treated with intravenous thrombolysis at the H elsinki U niversity C entral H ospital. Main outcome measures were modified Rankin Scale and neuropsychological examination at 3 months after thrombolysis. We further evaluated G oldmann visual field examination at 6 months. Results No acute findings appeared on admission non‐contrast head‐computed tomography scan. All patients had a perfusion deficit on admission‐computed tomography perfusion imaging. All patients scored 0 on 3‐month modified R ankin S cale, and their neuropsychological evaluation was normal. Goldmann examination revealed no visual field deficit in both female patients, and a modest visual field defect was detected in the male patient. Conclusions Our experience encourages application of intravenous thrombolytic treatment (especially when supported with multimodality neuroimaging) in patients with homonymous hemianopia, for which rehabilitation options are limited.