Intravenous thrombolysis in stroke patients with hyperdense middle cerebral artery sign |
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Authors: | D Georgiadis F Wirz H-C von Büdingen P Valko M Hund-Georgiadis K Nedeltchev V Rousson R W Baumgartner |
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Institution: | Departmentof Neurology, University of Zürich, Zürich;;Department of Neurorehabilitation, Rehabilitation Clinic Wald, Wald;;Department of Neurology, University of Bern, Bern;;and Department of Biostatistics, University of Zürich, Zürich, Switzerland |
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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 ≤ 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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Keywords: | cerebral infarction cerebral ischemia stroke thrombolysis |
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