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Dramatic recovery after IV thrombolysis in anterior circulation ischemic stroke: Predictive factors and prognosis

2014Journal article Open access
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dc.contributor.authorRocha, J
dc.contributor.authorPinho, J
dc.contributor.authorVaranda, S
dc.contributor.authorAmorim, J
dc.contributor.authorRocha, JR
dc.contributor.authorMaré, R
dc.contributor.authorFerreira, C
dc.date.accessioned2014-08-05T22:29:11Z
dc.date.available2014-08-05T22:29:11Z
dc.date.issued2014
dc.description.abstractBACKGROUND AND PURPOSE: Dramatic recovery (DR) after thrombolysis is dependent of vessel recanalization and is predictive of favorable clinical outcome. Successful recanalization is not equivalent to DR. Our objective was to assess its frequency and evaluate clinical and biochemical predictors and their prognosis. METHODS: We analyzed prospectively registered data from January 2007 to September 2012. All patients with anterior circulation stroke and NIHSS≥10 were included. Improvement of ≥10 or a score ≤3 24h after thrombolysis was defined as DR. RESULTS: In the 230 patients included, DR frequency was 23% (53 patients). DR group had lower admission NIHSS (14 vs 17, p=0.024), less total anterior circulation infarcts (p=0.009), more partial anterior circulation infarcts (p=0.003) and lower blood glucose on admission (118 vs 128mg/dL, p=0.013). All patients with DR had an Alberta Stroke Program Early CT Score (ASPECTS) ≥7, vs 89.3% without DR (p=0.013). Arterial recanalization, defined as hyperdense middle cerebral artery sign disappearance on control CT, was more frequent in the DR group (68.4% vs 14.1%, p<0.001). Intracranial hemorrhage on 24h-control CT scan was less frequent in the DR group (p<0.001). Multinomial logistic regression analysis showed that ASPECTS score was an independent predictor of DR (OR=2.35, 95%CI=1.32-4.16, p=0.003) and CT evidence of recanalization was independently associated with DR (OR=11.60, 95%CI, 3.02-44.53, p<0.001). CONCLUSION: DR is a frequent occurrence. ASPECTS score is an independent predictor of DR, which is also independently associated with CT evidence of middle cerebral artery recanalization.por
dc.identifier.citationClin Neurol Neurosurg. 2014 Jul 18;125C:19-23.por
dc.identifier.urihttp://hdl.handle.net/10400.23/674
dc.language.isoengpor
dc.peerreviewedyespor
dc.subjectAcidente Vascular Cerebralpor
dc.subjectFibrinolíticospor
dc.titleDramatic recovery after IV thrombolysis in anterior circulation ischemic stroke: Predictive factors and prognosispor
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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