This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Okada, Y. Articles by Fujishima, M. Search for Related Content PubMed PubMed Citation Articles by Okada, Y. Articles by Fujishima, M.

Stroke, Vol 23, 20-23, Copyright © 1992 by American Heart Association

ARTICLES

Early computed tomographic findings for thrombolytic therapy in patients with acute brain embolism

Y Okada, S Sadoshima, H Nakane, H Utsunomiya and M Fujishima
Department of Cerebrovascular Disease, St. Mary's Hospital, Kurume, Japan.

BACKGROUND AND PURPOSE: The benefits and safety of thrombolytic therapy was studied in patients with acute brain embolism. METHODS: We intravenously administered recombinant tissue plasminogen activator (20- 30 MU for 1 hour) to 10 patients with acute (less than 6 hours) brain embolism and examined the neurological outcomes in relation to the findings on computed tomography and angiography. RESULTS: The 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 (less than 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. CONCLUSIONS: Thrombolytic 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.

This article has been cited by other articles:

				D. M. Somford, P. J. Nederkoorn, D. R. Rutgers, L. J. Kappelle, W. P. T. M. Mali, and J. van der Grond Proximal and Distal Hyperattenuating Middle Cerebral Artery Signs at CT: Different Prognostic Implications Radiology, June 1, 2002; 223(3): 667 - 671. [Abstract] [Full Text] [PDF]

				S. Nakano, T. Iseda, H. Kawano, T. Yoneyama, T. Ikeda, and S. Wakisaka Correlation of Early CT Signs in the Deep Middle Cerebral Artery Territories with Angiographically Confirmed Site of Arterial Occlusion AJNR Am. J. Neuroradiol., April 1, 2001; 22(4): 654 - 659. [Abstract] [Full Text]

				H. Nakane, S. Ibayashi, K. Fujii, K. Irie, S. Sadoshima, and M. Fujishima Cerebral Blood Flow and Metabolism in Hypertensive Patients with Cerebral Infarction Angiology, September 1, 1995; 46(9): 801 - 810. [Abstract] [PDF]