التفاصيل البيبلوغرافية
| العنوان: |
Early Dramatic Recovery During Intravenous Tissue Plasminogen Activator Infusion ; Clinical Pattern and Outcome in Acute Middle Cerebral Artery Stroke |
| المؤلفون: |
Felberg, Robert A., Okon, Nicholas J., El-Mitwalli, Ashraf, Burgin, W. Scott, Grotta, James C., Alexandrov, Andrei V. |
| المصدر: |
Stroke ; volume 33, issue 5, page 1301-1307 ; ISSN 0039-2499 1524-4628 |
| بيانات النشر: |
Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: |
2002 |
| الوصف: |
Background and Purpose — Acute-stroke patients receiving standard intravenous tissue plasminogen activator (tPA) have been noted to experience early dramatic recoveries. The prevalence, clinical characteristics, and outcome of patients experiencing dramatic recovery is not well described. Methods — We prospectively studied all patients presenting with acute middle cerebral artery (MCA) stroke syndromes and transcranial Doppler (TCD) evidence of an MCA obstruction. All patients received intravenous tPA per the National Institute of Neurological and Communicative Disorders and Stroke protocol, with serial National Institutes of Health Stroke Scale (NIHSS) scores and continuous TCD monitoring. Dramatic recovery was defined as an improvement of ≥10 NIHSS points or a decrease to an NIHSS score of ≤3 by the end of infusion. Outcome at the end of infusion, at 24 hours, and at long-term follow-up were obtained. The timing and pattern of deficit recovery during dramatic recovery was also studied. Results — Dramatic recovery occurred in 22% of all patients. Compared with patients who did not experience dramatic recovery, those patients who did had significantly lower end-infusion NIHSS (median 2 and range 0 to 16 for dramatic-recovery patients versus median 17 and range 6 to 35 for non–dramatic-recovery patients, P <0.01) and 24-hour NIHSS (median 2 and range 0 to 16 for dramatic-recovery patients versus median 13 and range 2 to 35 for non–dramatic-recovery patients, P <0.01). A long-term modified Rankin Score benefit was noted (median 1 and range 0 to 6 for dramatic-recovery patients versus median 4 and range 0 to 6 for non–dramatic-recovery patients, P <0.01). Baseline clinical characteristics were similar. The only difference was improved TCD-determined flow values at the end of infusion (normal restoration of flow was 58% in dramatic-recovery patients versus 14% in non–dramatic-recovery patients, P <0.01). A characteristic pattern of recovery of deficit was noted. Conclusions — Early dramatic recovery in ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1161/01.str.0000015556.48283.74 |
| DOI: |
10.1161/01.STR.0000015556.48283.74 |
| الإتاحة: |
https://doi.org/10.1161/01.str.0000015556.48283.74Test |
| رقم الانضمام: |
edsbas.9C4E908E |
| قاعدة البيانات: |
BASE |
