Intravenous thrombolytic treatment of acute basilar artery occlusion

Acute stroke with basilar artery occlusion is a serious condition with high mortality and severe disability. We describe three patients with acute artery basilar occlusion treated with thrombolytic agent given intravenously. One patient demonstrated early and considerable clinical improvement parallel to thrombolytic therapy started two and a half hour after ictus, but suffered a new occlusion and died in a "locked-in syndrome". One patient demonstrated moderate clinical improvement after less than six hours and survived with disability. One patient demonstrated no clinical improvement with thrombolytic therapy started six hours after ictus and later died of an injured brainstem. No patients had serious bleeding. Intravenous, systemic thrombolytic treatment may have a beneficial effect in acute basilar occlusion.