Prognosis of aphasia in stroke patients early after iv thrombolysis

Autor: Fabienne Perren, Eufrozina Selariu, Kasim Abul-Kasim, Christine Kremer, Johan Kappelin
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Male
Neurology
Stroke patient
Iv thrombolysis
medicine.medical_treatment
Brain Ischemia/pathology
Neuropsychological Tests
Brain Ischemia
Risk Factors
Thrombolytic Therapy
Thrombolysis Stroke Aphasia Outcome
Stroke
Aged
80 and over
Neurologic Examination
Stroke Rehabilitation
Brain
Cerebral Infarction
General Medicine
Thrombolysis
Tissue Plasminogen Activator/administration & dosage/therapeutic use
Middle Aged
Prognosis
Aphasia/etiology/rehabilitation
Treatment Outcome
Cerebral Infarction/pathology
Tissue Plasminogen Activator
Infarct volume
Injections
Intravenous
Cardiology
Female
medicine.symptom
Adult
medicine.medical_specialty
behavioral disciplines and activities
Sex Factors
Fibrinolytic Agents
Fibrinolytic Agents/administration & dosage/therapeutic use
Internal medicine
Aphasia
medicine
Humans
Brain/pathology
Aged
business.industry
Stroke scale
medicine.disease
nervous system diseases
ddc:616.8
Stroke/complications/drug therapy/rehabilitation
Physical therapy
Surgery
Neurology (clinical)
business
Tomography
X-Ray Computed
Echocardiography
Transesophageal
Zdroj: Clinical Neurology and Neurosurgery, Vol. 115, No 3 (2013) pp. 289-292
Clinical Neurology and Neurosurgery; 115(3), pp 289-292 (2013)
ISSN: 0303-8467
1872-6968
Popis: OBJECTIVE: Stroke patients with aphasia have a high long-term morbidity. Intravenous rt-PA (iv) thrombolysis is given more deliberately to these patients. Early outcome data is lacking. Aim of this study was to determine early benefit from rt-PA in patients with aphasia. METHODS: Data of stroke patients treated by iv thrombolysis was scrutinized for the presence of aphasia defined as ≥1 point for aphasia on the National Institute of Health Stroke Scale (NIHSS). Improvement was defined as a gain of ≥1 point within 24h. Cranial computed tomography (CT) scans were evaluated regarding early ischemic changes (EICs), infarct volume and localization. RESULTS: Fifty patients with aphasia were included. 16 (32%) of patients improved (4 (36%) minor, 7 (41%) moderate, 5 (23%) major stroke patients), while 44 (62%) remained unchanged. Of 28 patients with EICs, 10 (36%) improved compared to 7 out of 22 (32%) patients without (p=0.773). Aphasia outcome was significantly associated with infarct volume at admission and at 24h (Kruskal-Wallis, p=0.033, p≤0.001, respectively). CONCLUSION: EICs are not predictive of aphasia outcome and patients with improvement showed smaller infarct volumes. One third improved within 24h, while two thirds remained unchanged. This might justify a closer follow-up of aphasia in stroke patients at the acute stage.
Databáze: OpenAIRE
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