Intravenous recombinant tissue plasminogen activator thrombolysis in acute ischemic stroke due to middle cerebral artery dissection.

Beneficial effect of recombinant tissue plasminogen activator (rtPA) in cerebral arterial dissection is controversial. We experienced a 45-year-old man with acute ischemic stroke due to middle cerebral artery dissection, who was treated with rtPA. Characteristic vascular findings indicating dissection became evident only in subsequent angiographic examinations. Our case indicates that serial angiographic examinations should be essential after acute thrombolytic therapy, especially in young patients who are at a high risk of cerebral arterial dissection.