PMID- 11296577
OWN - NLM
STAT- MEDLINE
DCOM- 20010517
LR  - 20191104
IS  - 1051-2284 (Print)
IS  - 1051-2284 (Linking)
VI  - 11
IP  - 2
DP  - 2001 Apr
TI  - Baseline computed tomography changes and clinical outcome after thrombolysis with 
      recombinant tissue plasminogen activator in acute ischemic stroke.
PG  - 101-4
AB  - Intravenous recombinant tissue plasminogen activator (rt-PA) is the only therapy 
      of proven value for patients with acute ischemic stroke (AIS). Controversy exists 
      with regard to the prognostic significance of early computed tomography (CT) 
      changes in patients receiving rt-PA for AIS. The authors retrospectively reviewed 
      all cases of AIS who received intravenous rt-PA for AIS in University of South 
      Alabama hospitals between January 1996 and May 1999. A neuroradiologist, blinded 
      to clinical outcomes, reviewed all baseline CT scans for the presence of the 
      following signs: hyperdense middle cerebral artery (HMCA), loss of gray-white 
      differentiation (LGWD), insular ribbon sign (IRS), parenchymal hypodensity (PH), 
      and sulcal effacement (SE). Modified Rankin Scale (mRS) score was recorded 90 
      days after thrombolysis, and clinical outcome was dichotomized as favorable (0-1) 
      or unfavorable (2-6). The authors performed both univariate and multivariate 
      analyses to investigate the relationship between early CT signs, baseline 
      clinical variables, and functional outcome as measured by the 90-day mRS scores. 
      Any one early CT finding was detected in 23(64%) patients. The frequency of 
      specific findings were as follows: SE in 13 patients (36%), LGWD in 12 patients 
      (33%), PH in 9 patients (25%), HMCA in 4 patients (11%), and IRS in 3 patients 
      (8%) patients. There was no statistically significant association between the 
      occurrence of these imaging findings and subsequent functional outcome after 
      thrombolysis. The data suggest that the presence of subtle acute CT changes in 
      AIS patients is not predictive of clinical outcome following administration of 
      rt-PA as per National Institute of Neurological Disorders and Stroke protocol.
FAU - Mendizabal, J E
AU  - Mendizabal JE
AD  - University of South Alabama Stroke Center, 2451 Fillingim Street, Mobile, AL 
      36617, USA. jmendiza@usamail.usouthal.edu
FAU - Lurie, D N
AU  - Lurie DN
FAU - Greiner, F G
AU  - Greiner FG
FAU - Shah, A K
AU  - Shah AK
FAU - Zweifler, R M
AU  - Zweifler RM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Neuroimaging
JT  - Journal of neuroimaging : official journal of the American Society of 
      Neuroimaging
JID - 9102705
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Infarction, Middle Cerebral Artery/*diagnostic imaging/drug therapy
MH  - Intracranial Embolism/*diagnostic imaging/drug therapy
MH  - Male
MH  - Middle Aged
MH  - Neurologic Examination
MH  - Prognosis
MH  - Retrospective Studies
MH  - *Thrombolytic Therapy
MH  - Tissue Plasminogen Activator/*administration & dosage
MH  - *Tomography, X-Ray Computed
EDAT- 2001/04/12 10:00
MHDA- 2001/05/18 10:01
CRDT- 2001/04/12 10:00
PHST- 2001/04/12 10:00 [pubmed]
PHST- 2001/05/18 10:01 [medline]
PHST- 2001/04/12 10:00 [entrez]
AID - 10.1111/j.1552-6569.2001.tb00018.x [doi]
PST - ppublish
SO  - J Neuroimaging. 2001 Apr;11(2):101-4. doi: 10.1111/j.1552-6569.2001.tb00018.x.