Early recurrent ischemic stroke in stroke patients undergoing intravenous thrombolysis

Georgiadis, Dimitrios; Engelter, Stefan; Tettenborn, Barbara; Hungerbühler, Hansjörg; Luethy, Regina; Müller, Felix; Arnold, Marcel; Giambarba, Christian; Baumann, Christian Rainer; von Büdingen, Hans-Christian; Lyrer, Philipp; Baumgartner, Ralf Werner (2006). Early recurrent ischemic stroke in stroke patients undergoing intravenous thrombolysis. Circulation, 114(3), pp. 237-41. Baltimore, Md.: Lippincott Williams & Wilkins 10.1161/CIRCULATIONAHA.105.597435

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BACKGROUND: We assessed the incidence of early recurrent ischemic stroke in stroke patients treated with intravenous tissue-type plasminogen activator (tPA) and the temporal pattern of its occurrence compared with symptomatic intracranial hemorrhage (ICH). METHODS AND RESULTS: Prospectively collected, population-based data for 341 consecutive acute stroke patients (62% men; mean age, 66 years) treated with tPA according to the National Institute of Neurological Disorders and Stroke study protocol at 8 medical centers in Switzerland (3 academic and 5 community) between January 2001 and November 2004 were retrospectively analyzed. The primary outcome measure was neurological deterioration > or = 4 points on the National Institutes of Health Stroke Scale occurring within 24 hours of tPA treatment and caused either by recurrent ischemic stroke (defined as the occurrence of new neurological symptoms suggesting involvement of initially unaffected vascular territories and evidence of corresponding ischemic lesions on cranial computed tomography scans, in the absence of ICH) or by ICH. Early recurrent ischemic stroke was diagnosed in 2 patients (0.59%; 95% confidence interval, 0.07% to 2.10%) and symptomatic ICH in 15 patients (4.40%; 95% confidence interval, 2.48% to 7.15%). Both recurrent ischemic strokes occurred during thrombolysis, whereas symptomatic ICHs occurred 2 to 22 hours after termination of tPA infusion. CONCLUSIONS: Recurrent ischemic stroke is a rare cause of early neurological deterioration in acute stroke patients undergoing intravenous thrombolysis, with a different temporal pattern compared with that of symptomatic ICH.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Arnold, Marcel

ISSN:

0009-7322

ISBN:

16831985

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:50

Last Modified:

17 Mar 2015 21:52

Publisher DOI:

10.1161/CIRCULATIONAHA.105.597435

PubMed ID:

16831985

Web of Science ID:

000239073500010

URI:

https://boris.unibe.ch/id/eprint/20955 (FactScience: 4767)

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