This trial is active, not recruiting.

Conditions motor weakness in two or four limbs, damage in the anterior spinal artery (asa), temperature and superficial sensation, urinary retention or bowel disorder
Treatment intravenuse alteplase
Phase phase 2
Sponsor Rabin Medical Center
Start date April 2016
End date October 2018
Trial size 12 participants
Trial identifier NCT02242084, AK 23 - 14


Ischemic stroke of the spinal cord is a rare disease accounting for about 1% of all ischemic events in the central nervous system (CNS). In most cases the consequences are catastrophic, with a high rate of severe functional disability and mortality rate up to 30%.

Ischemic stroke of the spinal cord can arise from:

1. Dissection of the aorta.

2. Aneurism in the aorta.

3. Atherosclerotic disease of the aorta or vertebral arteries.

4. Spinal surgeries.

5. Spinal AVM.

6. Embolism from cardiac origin.

7. Occlusion of radicular artery. Onset is usually sudden, reaching maximal intensity in hours until the patient becomes paralyzed in two or in all four limbs. In most cases the damage is in the Anterior Spinal Artery (ASA). The disease is expressed with motor weakness accompanied by disturbance of temperature and superficial sensation, urinary retention or bowel disorder, with preserved position and vibration sense.

The differential diagnosis of ischemic spinal cord includes diseases such as acute myelitis of the spinal cord or acute demyelinating polyneuropathy like Guillan Barree Syndrome (GBS). Therefore in order to reach the appropriate diagnosis in most cases an urgent MRI of the spinal cord is necessary upon arrival in the emergency department.

One of the treatments to acute ischemic stroke is providing thrombolysis. As tested and validated in numerous studies for ischemic events in the brain, until today no validated study in ischemic spinal stroke using thrombolysis has been completed.

United States No locations recruiting
Other countries No locations recruiting

Study Design

Intervention model single group assignment
Primary purpose treatment
Masking no masking
All subject who enter the trial will receive treatment with Alteplase along with questionnaire.
intravenuse alteplase

Primary Outcomes

Modified Ranking Scale (mRS)
time frame: 3 month post thrombolysis

Eligibility Criteria

All participants from 18 years up to 85 years old.

Inclusion Criteria: 1. Patients with vascular risk factors 2. Patients with sudden weakness of the lower or upper limbs together with bowel disorder. 3. Window treatment - not over 6 hours since the start of the event till the start of the treatment. 4. Patient without dissection of the aorta in the abdomen. 5. Patient without contraindication to IVtPA. 6. Patient with no etiology found after clarification. Exclusion Criteria: 1. Refusal to sign an ICF. 2. Reason for weakness is known. 3. Patient with contraindication IVtPA.

Additional Information

Official title Thrombolysis in Ischemic Spinal Cord Stroke
Principal investigator Israel Steiner, Professor
Trial information was received from ClinicalTrials.gov and was last updated in April 2017.
Information provided to ClinicalTrials.gov by Rabin Medical Center.