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Intravenous thrombolysis in stroke patients with hyperdense middle cerebral artery sign


Georgiadis, D; Wirz, F; von Büdingen, H C; Valko, P; Hund-Georgiadis, M; Nedeltchev, K; Rousson, V; Baumgartner, R W (2009). Intravenous thrombolysis in stroke patients with hyperdense middle cerebral artery sign. European Journal of Neurology, 16(2):162-167.

Abstract

BACKGROUND AND PURPOSE: We assessed the safety and efficacy of intravenous thrombolysis (IVT) in acute stroke patients with hyperdense middle cerebral artery sign (HMCAS). PATIENTS AND METHODS: Data from consecutive patients with acute (within 6 h of symptom onset) ischaemic stroke admitted between January 1999 and November 2007, in whom HMCAS was diagnosed on admission CT scan was retrospectively analysed. Seventy-one patients, admitted within the 3-h window, were treated with IVT, whilst further 42, admitted 3-6 h after symptom onset, were not. At 3-month clinical follow-up, outcome, mortality at 3 months and incidence of symptomatic intracranial haemorrhage were evaluated. RESULTS: The two groups were comparable concerning age, stroke risk factors, prior antithrombotic treatment and NIHSS scores on admission. Good outcome (mRS score <or= 1) was observed in 12/71 (17%) patients who were treated with IVT and in 1/42 (2%) patients who were not (P = 0.02). IVT treatment was identified as independent predictor of good outcome (P = 0.05). Mortality was 20% in patients treated with IVT and 12% in remaining patients (P = 0.3). Symptomatic intracranial haemorrhage occurred in 1 patient of each group (2%). CONCLUSIONS: These findings suggest that IVT in patients with HMCAS results in significantly better outcome, without significantly influencing mortality.

Abstract

BACKGROUND AND PURPOSE: We assessed the safety and efficacy of intravenous thrombolysis (IVT) in acute stroke patients with hyperdense middle cerebral artery sign (HMCAS). PATIENTS AND METHODS: Data from consecutive patients with acute (within 6 h of symptom onset) ischaemic stroke admitted between January 1999 and November 2007, in whom HMCAS was diagnosed on admission CT scan was retrospectively analysed. Seventy-one patients, admitted within the 3-h window, were treated with IVT, whilst further 42, admitted 3-6 h after symptom onset, were not. At 3-month clinical follow-up, outcome, mortality at 3 months and incidence of symptomatic intracranial haemorrhage were evaluated. RESULTS: The two groups were comparable concerning age, stroke risk factors, prior antithrombotic treatment and NIHSS scores on admission. Good outcome (mRS score <or= 1) was observed in 12/71 (17%) patients who were treated with IVT and in 1/42 (2%) patients who were not (P = 0.02). IVT treatment was identified as independent predictor of good outcome (P = 0.05). Mortality was 20% in patients treated with IVT and 12% in remaining patients (P = 0.3). Symptomatic intracranial haemorrhage occurred in 1 patient of each group (2%). CONCLUSIONS: These findings suggest that IVT in patients with HMCAS results in significantly better outcome, without significantly influencing mortality.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:22 Mar 2009 12:26
Last Modified:17 Feb 2018 22:40
Publisher:Wiley-Blackwell
ISSN:1351-5101
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/j.1468-1331.2008.02369.x
PubMed ID:19138342

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