Early Computed Tomographic Findings for Thrombolytic Therapy in Patients With Acute Brain Embolism
作者:
Yasushi Okada,
Seizo Sadoshima,
Hiroshi Nakane,
Hidetsuna Utsunomiya,
Masatoshi Fujishima,
期刊:
Stroke
(OVID Available online 1992)
卷期:
Volume 23,
issue 1
页码: 20-23
ISSN:0039-2499
年代: 1992
出版商: OVID
关键词: embolism;plasminogen activator, tissue-type tomography, x-ray computed;thrombolytic therapy
数据来源: OVID
摘要:
Background and PurposeThe benefits and safety of thrombolytic therapy was studied in patients with acute brain embolism.MethodsWe intravenously administered recombinant tissue plasminogen activator (20–30 MU for 1 hour) to 10 patients with acute (<6 hours) brain embolism and examined the neurological outcomes in relation to the findings on computed tomography and angiography.ResultsThe symptoms ameliorated in four patients within 24 hours after onset, and reopening of the occluded arteries occurred in two of the patients immediately after recombinant tissue plasminogen activator infusion. On the initial computed tomographic scan (<3 hours), four patients had already demonstrated early indications of brain ischemia, that is, an obscure margin of the lentiform nuclei, reduced tissue attenuation, or effacement of cortical sulci. These patients failed to demonstrate reopening of the occluded arteries, and one developed a massive brain hemorrhage with clinical deterioration. Of the remaining six patients, two obtained clinical improvement with recanalization soon after the therapy and demonstrated little to slight hemorrhagic complications. The outcomes at 1 month were favorable in five patients and poor in three; death occurred in two.ConclusionsThrombolytic therapy with recombinant tissue plasminogen activator may be safe and effective when there are no early computed tomographic findings within 3 hours from the onset of embolic stroke.
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