[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to assess the feasibility, clinical effect and safety of intravenous thrombolysis with tissue plasminogen activator in patients with acute ischaemic stroke treated in an acute stroke unit.
All patients admitted within 3 h after an acute ischaemic stroke were considered for thrombolysis. Twenty-four patients were treated.
Ten patients demonstrated early clinical improvement compatible with a positive effect of thrombolysis. Five patients demonstrated a substantial but slow clinical improvement with an uncertain relationship to thrombolysis. Nine patients did not improve. One patient developed an intracerebral haematoma and 2 developed a haemorrhagic infarction without clinical deterioration. Five patients (21%) died within the first 3 months. At follow-up after 6 months, 10 patients (42%) had achieved independence [modified Rankin Scale (mRS) 0-2], 9 (33%) had an unfavourable outcome (mRS 3-5) and 5 patients (21%) had died. None of these 5 patients died due to a treatment complication.
This study in a small patient population suggests that thrombolysis may be administered relatively safely in an acute stroke unit without intensive care facilities. The clinical effect and safety were similar to those which have been found in large randomised studies and clinical series.
No preview · Article · Feb 2002 · Cerebrovascular Diseases
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate neurological clinical findings and cerebral computed tomography (CT) findings in patients with acute stroke within six hours after stroke onset.
42 patients with presumed stroke in the middle cerebral artery territory were clinically assessed with the Scandinavian Stroke Scale Score. CT scans were assessed in a standardized manner by one neuroradiologist.
The clinical deficit did not forecast the CT findings. Patients with several early CT signs of ischaemia, and especially those with hypodensity in less than one third of the middle cerebral artery area had lower clinical scores than patients with fewer signs. Hypodensity in the insular region was the overall most frequent finding.
Clinical findings do not give definite information about the ischaemic damage in the acute phase of cerebral infarction. CT scans may give valuable information primarily when there are positive findings.
No preview · Article · Sep 2001 · Tidsskrift for Den norske legeforening