This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map 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 Overgaard, K. Articles by Videbaek, C. Search for Related Content PubMed PubMed Citation Articles by Overgaard, K. Articles by Videbaek, C.

Stroke, Vol 24, 1439-1446, Copyright © 1993 by American Heart Association

ARTICLES

Thrombolytic therapy in acute ischemic stroke. A Danish pilot study

K Overgaard, B Sperling, G Boysen, H Pedersen, J Gam, K Ellemann, A Karle, P Arlien-Soborg, TS Olsen and C Videbaek
Department of Neurology, University Hospital, Rigshospitalet, Copenhagen, Denmark.

BACKGROUND AND PURPOSE: In a feasibility and safety study of thrombolytic therapy in acute ischemic stroke, we explored the usefulness of measurements of regional cerebral blood flow. METHODS: Twenty-three patients with acute ischemic stroke were treated with 100 mg recombinant tissue plasminogen activator infused intravenously over 1 hour. Thrombolytic therapy was initiated 78 to 355 minutes after onset of symptoms. RESULTS: Angiography 16 to 24 hours after treatment in 17 patients showed patient intracranial arteries in 12, partial occlusion of the middle cerebral artery in 3, and total occlusion of the middle cerebral artery in 2. rCBF with 99mTc- hexamethylpropyleneamine oxime intravenously was measured 5 minutes before and within 24 hours after thrombolytic therapy in 12 patients. 10 of the 12 patients showed brain tissue reperfusion and 2, with angiographically documented middle cerebral artery occlusion, showed no reperfusion, thus documenting a relationship between reperfusion measured by regional cerebral blood flow and angiographic patency (P = .015). Three patients died. Patients who were reperfused within 24 hours (documented by repeated regional cerebral blood flow measurements) showed greater clinical improvement on the Scandinavian Stroke Scale the sooner their thrombolytic therapy was started and the more severe their neurological deficits. CONCLUSIONS: Acute cerebral ischemia can be documented by rCBF measurements without delay of thrombolytic therapy, and repeated rCBF measurements can reveal whether cerebral reperfusion has occurred. In our study, early reperfusion was associated with clinical improvement.

This article has been cited by other articles:

				J. Berrouschot, H. Barthel, S. Hesse, W. H. Knapp, D. Schneider, and R. von Kummer Reperfusion and Metabolic Recovery of Brain Tissue and Clinical Outcome After Ischemic Stroke and Thrombolytic Therapy Stroke, July 1, 2000; 31(7): 1545 - 1551. [Abstract] [Full Text] [PDF]

				J. Berrouschot, H. Barthel, J. Koster, S. Hesse, A. Rossler, W. H. Knapp, and D. Schneider Extracorporeal Rheopheresis in the Treatment of Acute Ischemic Stroke : A Randomized Pilot Study Stroke, April 1, 1999; 30(4): 787 - 792. [Abstract] [Full Text] [PDF]

				P. A. Barber, S. M. Davis, B. Infeld, A. E. Baird, G. A. Donnan, D. Jolley, and M. Lichtenstein Spontaneous Reperfusion After Ischemic Stroke Is Associated With Improved Outcome Stroke, December 1, 1998; 29(12): 2522 - 2528. [Abstract] [Full Text] [PDF]

				J. C. Grotta and A. V. Alexandrov tPA-Associated Reperfusion After Acute Stroke Demonstrated by SPECT Stroke, February 1, 1998; 29(2): 429 - 432. [Abstract] [Full Text] [PDF]

				B. Infeld, S. M. Davis, G. A. Donnan, M. Lichtenstein, A. E. Baird, D. Binns, P. J. Mitchell, and J. L. Hopper Streptokinase Increases Luxury Perfusion After Stroke Stroke, September 1, 1996; 27(9): 1524 - 1529. [Abstract] [Full Text]

				P. Trouillas, N. Nighoghossian, J.-C. Getenet, G. Riche, P. Neuschwander, J.-C. Froment, F. Turjman, J.-X. Jin, D. Malicier, G. Fournier, et al. Open Trial of Intravenous Tissue Plasminogen Activator in Acute Carotid Territory Stroke : Correlations of Outcome With Clinical and Radiological Data Stroke, May 1, 1996; 27(5): 882 - 890. [Abstract] [Full Text]

				R. U. Kothari, T. Brott, J. P. Broderick, and C. A. Hamilton Emergency Physicians : Accuracy in the Diagnosis of Stroke Stroke, December 1, 1995; 26(12): 2238 - 2241. [Abstract] [Full Text]