Thrombolysis in Stroke Patients with Isolated Aphasia
| Autor: | L. Bayon de la Tour, Christophe Vandendries, D Adams, Cécile Cauquil, C. Denier, Mariana Sarov, Constance Flamand-Roze, Olivier Chassin |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Stroke patient medicine.medical_treatment 030204 cardiovascular system & hematology Severity of Illness Index Brain Ischemia 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Aphasia Internal medicine Severity of illness Fibrinolysis medicine Humans Prospective Studies cardiovascular diseases Prospective cohort study Stroke Aged Aged 80 and over business.industry Thrombolysis Middle Aged medicine.disease nervous system diseases Treatment Outcome Neurology Tissue Plasminogen Activator Physical therapy Female Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Fibrinolytic agent |
| Zdroj: | Cerebrovascular Diseases. 41:163-169 |
| ISSN: | 1421-9786 1015-9770 |
| DOI: | 10.1159/000442303 |
| Popis: | Background: Data about evolution of aphasia following stroke are rare and controversial especially following fibrinolysis. The aim of this study was to describe the early clinical patterns of isolated aphasia in consecutive stroke patients with or without thrombolysis. Methods: Clinical and radiological data of consecutive stroke patients were routinely entered in prospective registry. Patients were considered aphasic when NIHSS (National Institutes of Health Stroke Scale) item 9 >0. ‘Isolated aphasia' was defined by aphasic patients without motor limb deficit. We created a ‘composite language score' obtained by summing the NIHSS items 1b, 1c and 9, which reflects language-processing ability. Recovery of functions was evaluated as measured by global NIHSS, composite language score and language screening test (LAST) at baseline, H24 and day 7 (D7). ‘Mild deficit' was defined as global NIHSS Results: A total of 100 consecutive patients met study criteria for isolated aphasia. Twenty-five underwent thrombolysis and 75 did not. There was no difference between the 2 groups concerning demographic characteristics, involved territories and presence of arterial occlusion, initial median NIHSS, composite language and LAST scores at entrance. Evolution was significantly better in thrombolysed patient for the 3 testings: NIHSS, composite language score and LAST at D7 (respective p = 0.0002; p = 0.01 and p = 0.004). Similar results were found when we focused on the subgroups of patients with initial ‘mild' deficits (p = 0.01; p = 0.0003 and p = 0.007). No symptomatic hemorrhagic transformation occurred following thrombolysis. Conclusion: These data strongly suggest that thrombolysis is safe and effective in patients with ‘isolated aphasia,' even if the global NIHSS score is |
| Databáze: | OpenAIRE |
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