Outcomes of patients with large middle cerebral artery infarct treated with and without intravenous thrombolysis

被引：14

作者：

Dharmasaroja, Pornpatr A. ^{[1
]}

Muengtaweepongsa, Sombat ^{[2
]}

机构：

[1] Thammasat Univ, Fac Med, Stroke & Neurodegenerat Dis Res Unit, Dept Internal Med, Pathum Thani 12120, Thailand

[2] Thammasat Univ, Fac Med, Dept Internal Med, Pathum Thani 12120, Thailand

来源：

JOURNAL OF NEUROSCIENCES IN RURAL PRACTICE | 2016年 / 7卷 / 01期

关键词：

Asia; middle cerebral artery; severe stroke; thrombolysis;

D O I：

10.4103/0976-3147.172149

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Many thrombolytic studies showed that severe stroke was associated with death and having symptomatic intracerebral hemorrhage and inversely related to a favorable outcome. Aims: The purpose of this study is to compare the outcomes of patients with acute large middle cerebral artery (MCA) infarction with and without intravenous recombinant-tissue-plasminogen activator (rtPA) treatment. Methods: Patients with acute, large MCA infarction (National Institute of Health Stroke Scale [NIHSS] > 15) who were treated during 2011-2014 were studied. The demographic data and the outcomes were compared between patients with and without intravenous rtPA treatment. Results: Two hundred and forty patients were included. Mean NIHSS score was 20. One hundred and twenty patients were treated with intravenous rtPA treatment. The patients with rtPA treatment had higher rates of favorable outcomes (39% vs. 17%, P < 0.001) and lower mortality rate (16% vs. 51%, P < 0.001). There was no significant difference in the occurrence of symptomatic intracerebral hemorrhage (6% vs. 4%, P = 0.715). Conclusions: The study showed the benefit and safety of intravenous rtPA treatment in patients with acute large MCA infarct.

引用

页码：36 / 39

页数：4

共 16 条

[1] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[2] Mortality of space-occupying ('malignant') middle cerebral artery infarction under conservative intensive care [J].

Berrouschot, J ;

Sterker, M ;

Bettin, S ;

Koster, J ;

Schneider, D .

INTENSIVE CARE MEDICINE, 1998, 24 (06) :620-623

[3] Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection [J].

Campbell, B. C. V. ;

Mitchell, P. J. ;

Kleinig, T. J. ;

Dewey, H. M. ;

Churilov, L. ;

Yassi, N. ;

Yan, B. ;

Dowling, R. J. ;

Parsons, M. W. ;

Oxley, T. J. ;

Wu, T. Y. ;

Brooks, M. ;

Simpson, M. A. ;

Miteff, F. ;

Levi, C. R. ;

Krause, M. ;

Harrington, T. J. ;

Faulder, K. C. ;

Steinfort, B. S. ;

Priglinger, M. ;

Ang, T. ;

Scroop, R. ;

Barber, P. A. ;

McGuinness, B. ;

Wijeratne, T. ;

Phan, T. G. ;

Chong, W. ;

Chandra, R. V. ;

Bladin, C. F. ;

Badve, M. ;

Rice, H. ;

de Villiers, L. ;

Ma, H. ;

Desmond, P. M. ;

Donnan, G. A. ;

Davis, S. M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1009-1018

[4]

Christou I, 2001, INT ANGIOL, V20, P208

[5] Predictors of good outcome after intravenous tPA for acute ischemic stroke [J].

Demchuk, AM ;

Tanne, D ;

Hill, MD ;

Kasner, SE ;

Hanson, S ;

Grond, M ;

Levine, SR .

NEUROLOGY, 2001, 57 (03) :474-480

[6] Intracerebral hemorrhage following intravenous thrombolysis in Thai patients with acute ischemic stroke [J].

Dharmasaroja, Pornpatr A. ;

Muengtaweepongsa, Sombat ;

Pattaraarchachai, Junya ;

Dharmasaroja, Permphan .

JOURNAL OF CLINICAL NEUROSCIENCE, 2012, 19 (06) :799-803

[7] Outcomes of Thai patients with acute ischemic stroke after intravenous thrombolysis [J].

Dharmasaroja, Pornpatr A. ;

Dharmasaroja, Permphan ;

Muengtaweepongsa, Sombat .

JOURNAL OF THE NEUROLOGICAL SCIENCES, 2011, 300 (1-2) :74-77

[8] NIHSS score and arteriographic findings in acute ischemic stroke [J].

Fischer, U ;

Arnold, M ;

Nedeltchev, K ;

Brekenfeld, C ;

Ballinari, P ;

Remonda, L ;

Schroth, G ;

Mattle, HP .

STROKE, 2005, 36 (10) :2121-2125

[9] Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke [J].

Goyal, M. ;

Demchuk, A. M. ;

Menon, B. K. ;

Eesa, M. ;

Rempel, J. L. ;

Thornton, J. ;

Roy, D. ;

Jovin, T. G. ;

Willinsky, R. A. ;

Sapkota, B. L. ;

Dowlatshahi, D. ;

Frei, D. F. ;

Kamal, N. R. ;

Montanera, W. J. ;

Poppe, A. Y. ;

Ryckborst, K. J. ;

Silver, F. L. ;

Shuaib, A. ;

Tampieri, D. ;

Williams, D. ;

Bang, O. Y. ;

Baxter, B. W. ;

Burns, P. A. ;

Choe, H. ;

Heo, J. -H. ;

Holmstedt, C. A. ;

Jankowitz, B. ;

Kelly, M. ;

Linares, G. ;

Mandzia, J. L. ;

Shankar, J. ;

Sohn, S. -I. ;

Swartz, R. H. ;

Barber, P. A. ;

Coutts, S. B. ;

Smith, E. E. ;

Morrish, W. F. ;

Weill, A. ;

Subramaniam, S. ;

Mitha, A. P. ;

Wong, J. H. ;

Lowerison, M. W. ;

Sajobi, T. T. ;

Hill, M. D. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1019-1030

[10] 'Malignant' middle cerebral artery territory infarction - Clinical course and prognostic signs [J].

Hacke, W ;

Schwab, S ;

Horn, M ;

Spranger, M ;

DeGeorgia, M ;

vonKummer, R .

ARCHIVES OF NEUROLOGY, 1996, 53 (04) :309-315

← 1 2 →