Prompt Recanalizaton of Basilar Artery (Lazarus Effect) in Patient with Acute Ischemic Cardioembolic Stroke in Spite of Relatively Late Start of Fibrinolytic Therapy

Yarovinsky N, Eran A and Telman G

Introduction: Full and fast restoration of cerebral blood flow in proximity to the initiation of intravenous tissue plasminogen activator (IV tPA) treatment occurs in 10 % of patients with acute ischemic stroke. This phenomenon is also known as Lazarus effect. "Lazarus" pattern of cerebral blood vessel recanalization is attributed mainly to internal carotid artery and middle cerebral artery occlusions and is not frequent in basilar artery occlusions.

Methods and Results: We present here a case of Lazarus effect in patient with severe stroke due to occlusion of basilar artery treated with IV tPA more than three hours after the onset of stroke (190 minutes).

Conclusion: Our case emphasizes the importance of treatment with IV tPA as initial one before the use of intraarterial tPA, in patients with total occlusion of main cerebral vessels, even in cases with relatively late initiation of treatment.