Factors Affecting the Angiographic Recanalization and Early Clinical Improvement in Middle Cerebral Artery Territory Infarction After Thrombolysis
| Autor: | Choong G. Choi, Jee-Hyun Kwon, Dae Chul Suh, Ju H. Lee, Jong S. Kim, Sun U. Kwon |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Carotid Artery Diseases
Male medicine.medical_specialty Health Status medicine.medical_treatment Infarction Posterior cerebral artery Magnetic resonance angiography Fibrinolytic Agents Arts and Humanities (miscellaneous) medicine.artery medicine Humans Aged Retrospective Studies medicine.diagnostic_test business.industry Infarction Middle Cerebral Artery Cerebral Infarction Thrombolysis Middle Aged Prognosis medicine.disease Treatment Outcome Cerebrovascular Circulation Middle cerebral artery Angiography Female Neurology (clinical) Radiology Internal carotid artery business Magnetic Resonance Angiography Fibrinolytic agent |
| Zdroj: | Archives of Neurology. 61:1682 |
| ISSN: | 0003-9942 |
| DOI: | 10.1001/archneur.61.11.1682 |
| Popis: | Factors affecting the angiographic recanalization (AR) and clinical improvement (CI) still remain unclear in patients receiving thrombolytic therapy.To elucidate factors related to AR and early CI in patients with middle cerebral artery (MCA) or internal carotid artery (ICA) occlusion.Retrospective study.Department of Neurology, Asan Medical Center, Seoul, South Korea.We studied 42 patients who (1) underwent diffusion-weighted magnetic resonance (MR) imaging and MR angiography within 6 hours after onset, (2) had MCA territory infarction, (3) had nonvisualization of the MCA or the ICA on initial MR angiography, (4) were treated with thrombolytics, and (5) underwent follow-up MR imaging and MR angiography at day 2 or 3.Successful AR and CI were achieved in 31 and 16 patients, respectively. Angiographic recanalization was related to CI (P.01), lower follow-up National Institutes of Health Stroke Scale scores (P.05), the absence of a dominant ipsilateral posterior cerebral artery (P.01) on initial MR angiography, and the sparing of the internal capsule on both initial (P.05) and follow-up (P.01) MR imaging. Clinical improvement was associated with the absence of ICA (vs MCA) flow signals (P.05), the sparing of the internal capsule (P.01), and marginally, with the infarct volume change (P = .06).In patients with MCA or ICA occlusion, CI after thrombolysis is related to the AR and the sparing of the critical motor pathway. The presence of a dominant ipsilateral posterior cerebral artery may predict poor AR after thrombolysis. |
| Databáze: | OpenAIRE |
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