Hemiplegia and thrombolysis.
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| Title: | Hemiplegia and thrombolysis. |
|---|---|
| Authors: | Meretoja, A., Strbian, D., Putaala, J., Kaste, M., Tatlisumak, T. |
| Source: | European Journal of Neurology. Sep2012, Vol. 19 Issue 9, p1235-1238. 4p. 2 Charts. |
| Subjects: | Hemiplegia, Thrombolytic therapy, Stroke patients, Health outcome assessment, Hemorrhage, Bedridden persons |
| Abstract: | Background and purpose Hemiplegia at stroke onset may be considered a contraindication for thrombolytic therapy. We describe the outcome of patients with ischaemic stroke presenting with hemiplegia and treated with intravenous alteplase (t PA). Methods All patients treated with t PA for acute ischaemic stroke between 1995 and 2010 were prospectively recorded in the Helsinki Stroke Thrombolysis Registry. Patients with basilar artery occlusion ( BAO) were excluded. Hemiplegia was defined as no visible voluntary movement on ipsilateral arm and leg. Results Of all treated patients ( n = 1579), we excluded those with BAO ( n = 152). Of remaining 1427 patients, 81 (6%) had hemiplegia at baseline. By 24 h, three had died and 20 retained their total hemiplegia. At day 7, a further nine had died, and 10 had persistent hemiplegia. A good 3-month outcome, modified Rankin Scale (m RS, 0-2), was observed in 23%, independence in ambulatory function (m RS 3) in further 16%, while 9% were bedridden and 20% dead. A wide clinical spectrum of neurological deficits coexisted with hemiplegia. With advanced age, more neurological functions lost, and with early radiological signs, the prognosis of patients with hemiplegia deteriorated. With combined fixed eye deviation ( n = 23), half were either bedridden ( n = 3) or dead ( n = 9) by 3 months, and fatal intracerebral haemorrhage were common ( n = 5). Conclusions Hemiplegia at presentation should not prevent thrombolytic therapy by itself, as limb movements are likely to return, and two of five thrombolysis-treated patients will walk independently by 3 months. With combined fixed eye deviation, the outcome is poorer and haemorrhagic complications are common. [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 78547457 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Hemiplegia and thrombolysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Meretoja%2C+A%2E%22">Meretoja, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Strbian%2C+D%2E%22">Strbian, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Putaala%2C+J%2E%22">Putaala, J.</searchLink><br /><searchLink fieldCode="AR" term="%22Kaste%2C+M%2E%22">Kaste, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Tatlisumak%2C+T%2E%22">Tatlisumak, T.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Sep2012, Vol. 19 Issue 9, p1235-1238. 4p. 2 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Hemiplegia%22">Hemiplegia</searchLink><br /><searchLink fieldCode="DE" term="%22Thrombolytic+therapy%22">Thrombolytic therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke+patients%22">Stroke patients</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Hemorrhage%22">Hemorrhage</searchLink><br /><searchLink fieldCode="DE" term="%22Bedridden+persons%22">Bedridden persons</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background and purpose Hemiplegia at stroke onset may be considered a contraindication for thrombolytic therapy. We describe the outcome of patients with ischaemic stroke presenting with hemiplegia and treated with intravenous alteplase (t PA). Methods All patients treated with t PA for acute ischaemic stroke between 1995 and 2010 were prospectively recorded in the Helsinki Stroke Thrombolysis Registry. Patients with basilar artery occlusion ( BAO) were excluded. Hemiplegia was defined as no visible voluntary movement on ipsilateral arm and leg. Results Of all treated patients ( n = 1579), we excluded those with BAO ( n = 152). Of remaining 1427 patients, 81 (6%) had hemiplegia at baseline. By 24 h, three had died and 20 retained their total hemiplegia. At day 7, a further nine had died, and 10 had persistent hemiplegia. A good 3-month outcome, modified Rankin Scale (m RS, 0-2), was observed in 23%, independence in ambulatory function (m RS 3) in further 16%, while 9% were bedridden and 20% dead. A wide clinical spectrum of neurological deficits coexisted with hemiplegia. With advanced age, more neurological functions lost, and with early radiological signs, the prognosis of patients with hemiplegia deteriorated. With combined fixed eye deviation ( n = 23), half were either bedridden ( n = 3) or dead ( n = 9) by 3 months, and fatal intracerebral haemorrhage were common ( n = 5). Conclusions Hemiplegia at presentation should not prevent thrombolytic therapy by itself, as limb movements are likely to return, and two of five thrombolysis-treated patients will walk independently by 3 months. With combined fixed eye deviation, the outcome is poorer and haemorrhagic complications are common. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/j.1468-1331.2012.03729.x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 4 StartPage: 1235 Subjects: – SubjectFull: Hemiplegia Type: general – SubjectFull: Thrombolytic therapy Type: general – SubjectFull: Stroke patients Type: general – SubjectFull: Health outcome assessment Type: general – SubjectFull: Hemorrhage Type: general – SubjectFull: Bedridden persons Type: general Titles: – TitleFull: Hemiplegia and thrombolysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Meretoja, A. – PersonEntity: Name: NameFull: Strbian, D. – PersonEntity: Name: NameFull: Putaala, J. – PersonEntity: Name: NameFull: Kaste, M. – PersonEntity: Name: NameFull: Tatlisumak, T. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: Sep2012 Type: published Y: 2012 Identifiers: – Type: issn-print Value: 13515101 Numbering: – Type: volume Value: 19 – Type: issue Value: 9 Titles: – TitleFull: European Journal of Neurology Type: main |
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