Intravenous thrombolysis in thromboembolic occlusion of the A1 segment of the left anterior cerebral artery only

This case describes the treatment of an 84-year-old male patient with acute bi-frontal ischemic stroke, due to thromboembolic occlusion of the A1 segment of the left anterior cerebral artery (ACA) only. The National Institutes of Health Stroke Scale (NIHSS) was 11. Intravenous fibrinolysis was performed with a good outcome. Repermeabilization of both ACA was demonstrated by imaging and, 24 h after treatment, NIHSS was 0. Although intravenous thrombolysis is mostly used for middle cerebral artery occlusion, this case emphasizes the benefit of this treatment for an ischemic stroke due to embolization of the A1 segment of the left ACA only. It is all the more original in that it describes an unusual treatment for this arterial territory, and with this anatomic particularity.