Good outcomes in ischemic stroke patients treated with intravenous thrombolysis despite regressing neurological symptoms

被引：68

作者：

Baumann, CR ^{[1
]}

Baumgartner, RW ^{[1
]}

Gandjour, J ^{[1
]}

von Büdingen, HC ^{[1
]}

Siegel, AM ^{[1
]}

Georgiadis, D ^{[1
]}

机构：

[1] Univ Zurich, Dept Neurol, Zurich, Switzerland

来源：

STROKE | 2006年 / 37卷 / 05期

关键词：

cerebrovascular disorder; thrombolysis;

D O I：

10.1161/01.STR.0000217272.38455.a2

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-We evaluated the clinical course of 19 acute stroke patients with rapid early improvement of neurological deficit within the 3-hour window, treated with intravenous thrombolytics. Results-No patient demonstrated a neurological deterioration during hospitalization. National Institutes of Health Stroke Scale (NIHSS) scores at therapy decision and discharge were 5 (4 to 6) and 0.5 (0 to 1.5), respectively. At 3-month follow-up, 1 patient had died; in remaining patients, NIHSS was 0(0 to 1) and modified Rankin Scale 0.5 (0 to 1; <= 1 in 15 patients). Conclusions-Withholding of intravenous thrombolysis because of spontaneous early regression of neurological symptoms may not be justified.

引用

页码：1332 / 1333

页数：2

共 7 条

[1] Guidelines for the Early Management of Patients With Ischemic Stroke - 2005 guidelines update - A scientific statement from the Stroke Council of the American Heart Association/American Stroke Association [J].

Adams, H ;

Adams, R ;

Del Zoppo, G ;

Goldstein, LB .

STROKE, 2005, 36 (04) :916-923

[2] CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].

ADAMS, HP ;

BENDIXEN, BH ;

KAPPELLE, LJ ;

BILLER, J ;

LOVE, BB ;

GORDON, DL ;

MARSH, EE ;

KASE, CS ;

WOLF, PA ;

BABIKIAN, VL ;

LICATAGEHR, EE ;

ALLEN, N ;

BRASS, LM ;

FAYAD, PB ;

PAVALKIS, FJ ;

WEINBERGER, JM ;

TUHRIM, S ;

RUDOLPH, SH ;

HOROWITZ, DR ;

BITTON, A ;

MOHR, JP ;

SACCO, RL ;

CLAVIJO, M ;

ROSENBAUM, DM ;

SPARR, SA ;

KATZ, P ;

KLONOWSKI, E ;

CULEBRAS, A ;

CAREY, G ;

MARTIR, NI ;

FICARRA, C ;

HOGAN, EL ;

CARTER, T ;

GURECKI, P ;

MUNTZ, BK ;

RAMIREZLASSEPAS, M ;

TULLOCH, JW ;

QUINONES, MR ;

MENDEZ, M ;

ZHANG, SM ;

ALA, T ;

JOHNSTON, KC ;

ANDERSON, DC ;

TARREL, RM ;

NANCE, MA ;

BUDLIE, SR ;

DIERICH, M ;

HELGASON, CM ;

HIER, DB ;

SHAPIRO, RA .

STROKE, 1993, 24 (01) :35-41

[3] Why are stroke patients excluded from TPA therapy? An analysis of patient eligibility [J].

Barber, PA ;

Zhang, J ;

Demchuk, AM ;

Hill, MD ;

Buchan, AM .

NEUROLOGY, 2001, 56 (08) :1015-1020

[4] Reasons for exclusion from thrombolytic therapy following acute ischemic stroke [J].

Cocho, D ;

Belvís, R ;

Martí-Fàbregas, J ;

Molina-Porcel, L ;

Díaz-Manera, J ;

Aleu, A ;

Pagonabarraga, J ;

García-Bargo, D ;

Mauri, A ;

Martí-Vilalta, JL .

NEUROLOGY, 2005, 64 (04) :719-720

[5] TISSUE-PLASMINOGEN ACTIVATOR FOR ACUTE ISCHEMIC STROKE [J].

MARLER, JR ;

BROTT, T ;

BRODERICK, J ;

KOTHARI, R ;

ODONOGHUE, M ;

BARSAN, W ;

TOMSICK, T ;

SPILKER, J ;

MILLER, R ;

SAUERBECK, L ;

JARRELL, J ;

KELLY, J ;

PERKINS, T ;

MCDONALD, T ;

RORICK, M ;

HICKEY, C ;

ARMITAGE, J ;

PERRY, C ;

THALINGER, K ;

RHUDE, R ;

SCHILL, J ;

BECKER, PS ;

HEATH, RS ;

ADAMS, D ;

REED, R ;

KLEI, M ;

HUGHES, S ;

ANTHONY, J ;

BAUDENDISTEL, D ;

ZADICOFF, C ;

RYMER, M ;

BETTINGER, I ;

LAUBINGER, P ;

SCHMERLER, M ;

MEIROSE, G ;

LYDEN, P ;

RAPP, K ;

BABCOCK, T ;

DAUM, P ;

PERSONA, D ;

BRODY, M ;

JACKSON, C ;

LEWIS, S ;

LISS, J ;

MAHDAVI, Z ;

ROTHROCK, J ;

TOM, T ;

ZWEIFLER, R ;

DUNFORD, J ;

ZIVIN, J .

NEW ENGLAND JOURNAL OF MEDICINE, 1995, 333 (24) :1581-1587

[6] Thrombolytic therapy for acute ischemic stroke: Why the majority of patients remain ineligible for treatment [J].

O'Connor, RE ;

McGraw, P ;

Edelsohn, L .

ANNALS OF EMERGENCY MEDICINE, 1999, 33 (01) :9-14

[7] Poor outcomes in patients who do not receive intravenous tissue plasminogen activator because of mild or improving ischemic stroke [J].

Smith, EE ;

Abdullah, AR ;

Petkovska, I ;

Rosenthal, E ;

Koroshetz, WJ ;

Schwamm, LH .

STROKE, 2005, 36 (11) :2497-2499

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