Neurologic Image Eur Neurol 2018;80:149–150 Intravenous Thrombolysis in Middle Cerebral Artery Occlusion Associated with Transient Symptoms Dimitri Renard a Marie De Verdal a Caroline Arquizan b Nicolas Menjot de Champfleur c Eric Thouvenot a, d a Department of Neurology, Nîmes University Hospital, Nîmes, France; b Department of Neurology, Montpellier University Hospital, Montpellier, France; c Department of Medical Imaging, Nîmes University Hospital, Nîmes, France; d Institut de Génomique Fonctionnelle, UMR5203, Université Montpellier, Montpellier, France Received: June 26, 2018 Accepted: October 5, 2018 Published online: November 21, 2018 Dimitri Renard, MD Department of Neurology Nîmes University Hospital 4, Rue du Pr Debré, FR–30029 Nîmes Cedex 4 (France) E-Mail dimitrirenard @hotmail.com © 2018 S. Karger AG, Basel E-Mail karger@karger.com www.karger.com/ene DOI: 10.1159/000494669 We present 2 patients with acute transient neurolog- ical deficit with middle cerebral artery (MCA) occlusion (segment M1) treated with intravenous thrombolysis (IVT) 150 and 225 min after symptom onset, respec- tively, both asymptomatic (NIHSS 0) at the time of treat- ment (Figure 1). IVT decision was based on the presence of proximal M1 occlusion, DWI/PWI mismatch, and risk of clinical worsening (Figure 1). Both patients re- mained asymptomatic and showed MCA recanalization on CT angiography de day after. Data on IVT and me- chanical thrombectomy in selected minor stroke pa- tients suggest that these treatments are safe and associ- ated with good outcome [1, 2]. Natural history and in- dications in patients with transient symptoms and MCA occlusion have to be determined. Statement of Ethics Subjects gave their informed consent for the study. The study pro- tocol was approved by the institute’s committee on human research. Disclosure Statement We have no conflicts of interest to declare. References 1 Heldner MR, Jung S, Zubler C, et al: Outcome of patients with occlusions of the internal carotid artery or the main stem of the middle cerebral artery with NIHSS score of less than 5:comparison between thrombolysed and non- thrombolysed patients. J Neurol Neurosurg Psychiatry 2015;86:755–760. 2 Dargazanli C, Arquizan C, Gory B, et al; ETIS REGISTRY Investigators: Mechanical thrombectomy for minor and mild stroke patients harboring large vessel occlusion in the anterior circulation: a multicenter cohort study. Stroke 2017;48:3274–3281. Downloaded by: Göteborgs Universitet 130.241.16.16 - 12/5/2018 10:59:28 PM