Thrombolytic drugs have been used in recent years as an effective therapeutic option in ischemic stroke. There are several experiences with the administration of thrombolytic therapy in basic and rural hospitals. We are describing our experience with four cases in which this treatment was used in our basic hospital during the last three years. We used a strict protocol described in the National Institute of Neurological Disorders and Stroke (NINDS) rt-PA stroke study. No intracranial hemorrhage or protocol violations were detected. We conclude that this protocol has allowed us to offer safe treatment to our ischemic stroke patients.

functional deficit improved with various occupational and speech therapy strategies and treatments. Conclusions: Perceptual visual deficits is a rare phenomena and is typically observed when there is bilateral occipital lobe involvement. Knowledge of how to evaluate and distinguish clinically the perceptual deficits with the actual visual loss is important to execute the appropriate rehabilitation course.

participate in the study (mean number of visits ¼ 2). Inclusion criteria: less than one year of age and no previous exposure to plagiocephaly cranial remolding therapy or surgical intervention. Interventions: Not applicable Main Outcome Measures: Reported measures include patient demographics and birth history (delivery type, presentation, induction of labor, birth aid, shoulder dystocia and torticollis); NBPP factors include palsy side, Narakas score and range of motion (shoulder flexion in adduction and elbow flexions in abduction). Cranial diagonal difference and cephalic index were measured to determine plagiocephaly factors. Results or Clinical Course: There were a total of twenty babies (71%) observed with plagiocephaly throughout the study (eight resolved). Shoulder dystocia was found to be prevalent among the group (46%) and was more common along the resolved group (88%, P¼.02). Babies in the non-plagio group generally exhibited more active range of motion in shoulder flexion, elbow flexion abduction and adduction than babies with plagio. All other factors had no significant correlations. Conclusion: High prevalence of plagiocephaly exists among the NBPP population examined. Shoulder dystocia may be an important feature that can be used as a predictive quality in the future. In summary, parents and physicians should encourage infants to use their upper extremity to change position; for example, tummy time, could be introduced in order to strength the muscle and potentially reduce chance of cranial asymmetry.