Brainstem hyperperfusion syndrome after intravenous thrombolysis: A case report

Chi Ieong Lau, Li-Ming Lien, Wei-Hung Chen

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


BACKGROUND AND PURPOSE: Recombinant tissue plasminogen activator (rtPA)-associated hyperperfusion syndrome in brainstem after acute stroke has not yet been reported. The current report demonstrates that rtPA-associated hyperperfusion syndrome can be a cause of clinical deterioration following improvement (DFI) after rtPA in acute stroke. METHODS: We observed a transient DFI in a 59-year-old man with acute ischemic stroke who received rtPA. The phenomenon was assessed by magnetic resonance imaging (MRI) with diffusion-weighted image (DWI) and a series of transcranial Doppler scan evaluating changes in the basilar arterial flow. RESULTS: We demonstrated a reversible hyperintensity at pons on DWI as well as a transient increase in basilar arterial flow on Doppler scan suggesting the occurrence of vasogenic edema and hyperperfusion at brainstem. CONCLUSIONS: rtPA-associated hyperperfusion can occur at brainstem causing transient neurological deficits. It can be a cause of DFI in addition to reocclusion after recanalization.

Original languageEnglish
Pages (from-to)277-279
Number of pages3
JournalJournal of Neuroimaging
Issue number3
Publication statusPublished - Jul 2011


  • Brainstem
  • Hyperperfusion
  • RtPA
  • Thrombolysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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