Association of Hyperdense Middle Cerebral Artery Sign With Clinical Outcome in Patients Treated With Tissue Plasminogen Activator
| Autor: | Stefano Bastianello, Rüdiger von Kummer, Luigi Bozzao, Emmanuel Lesaffre, Vincent Larrue, Françoise Iweins, Claude Manelfe, Peter A. Ringleb |
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| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty Pathology medicine.medical_treatment Hemiplegia Tissue plasminogen activator Disability Evaluation Plasminogen Activators Radiologic sign Double-Blind Method medicine.artery Internal medicine Fibrinolysis medicine Humans Thrombolytic Therapy Thrombus Stroke Aged Neurologic Examination Advanced and Specialized Nursing T-plasminogen activator business.industry Vascular disease Intracranial Embolism and Thrombosis Middle Aged medicine.disease Cerebrovascular Disorders Logistic Models Treatment Outcome Acute Disease Middle cerebral artery Cardiology Female Neurology (clinical) Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.30.4.769 |
| Popis: | Background and Purpose —The hyperdense middle cerebral artery sign (HMCAS) is a marker of thrombus in the middle cerebral artery. The aim of our study was to find out the frequency of the HMCAS, its association with initial neurological severity and early parenchymal ischemic changes on CT, its relevance to clinical outcome, and the efficacy of intravenous recombinant tissue plasminogen activator (rtPA) in patients with the HMCAS. Methods —Secondary analysis of the data from 620 patients who received either rtPA or placebo in the European Cooperative Acute Stroke Study I (ECASS I), a double-blind, randomized, multicenter trial. The baseline CT scans were obtained within 6 hours from the onset of symptoms. Functional and neurological outcomes were assessed using the modified Rankin Scale and the Scandinavian Stroke Scale at day 90. Results —We found an HMCAS in 107 patients(17.7%). The initial neurological deficit was more severe in patients with the HMCAS than in those lacking this sign ( P P P P =0.0297). Conclusions —The HMCAS is associated with severe brain ischemia and poor functional outcome. However, it has no significant independent prognostic value when accounting for the effect of initial severity of neurological deficit and of early parenchymal ischemic changes on CT. Patients with the HMCAS may benefit from intravenous rtPA. |
| Databáze: | OpenAIRE |
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