RESUMO
BACKGROUND: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Recent observations raised concern that IVT might cause harm in patients with strokes attributable to small artery occlusion (SAO). OBJECTIVE: The safety of IVT in SAO-patients is addressed in this study. METHODS: We used the Swiss IVT databank to compare outcome and complications of IVT-treated SAO-patients with IVT-treated patients with other etiologies (non-SAO-patients). Main outcome and complication measures were independence (modified Rankin scale
Assuntos
Arteriopatias Oclusivas/complicações , Isquemia Encefálica/etiologia , Isquemia Encefálica/terapia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/terapia , Terapia Trombolítica , Ativador de Plasminogênio Tecidual/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Bases de Dados Factuais , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Recidiva , Resultado do TratamentoRESUMO
This databank-based, multicenter study compared all stroke patients with IV tissue plasminogen activator aged > or = 80 years (n = 38) and those < 80 years old (n = 287). Three-month mortality was higher in older patients. Favorable outcome (modified Rankin scale < or = 1) and intracranial hemorrhage (asymptomatic/symptomatic/fatal) were similarly frequent in both groups. Logistic regression showed that stroke severity, time to thrombolysis, glucose level, and history of coronary heart disease independently predicted outcome, whereas age did not.
Assuntos
Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/mortalidade , Terapia Trombolítica/estatística & dados numéricos , Ativador de Plasminogênio Tecidual/uso terapêutico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Glicemia/fisiologia , Estudos de Coortes , Doença da Artéria Coronariana/complicações , Bases de Dados Factuais , Progressão da Doença , Feminino , Humanos , Infusões Intravenosas/normas , Infusões Intravenosas/estatística & dados numéricos , Hemorragias Intracranianas/induzido quimicamente , Hemorragias Intracranianas/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Mortalidade/tendências , Seleção de Pacientes , Acidente Vascular Cerebral/fisiopatologia , Suíça/epidemiologia , Terapia Trombolítica/normas , Fatores de TempoRESUMO
The feasibility and safety of induced arterial hypertension (10 to 20% of the initial value) in the acute phase of ischemic stroke were retrospectively evaluated in 34 patients treated with norepinephrine (NE) for a median of 26 hours. Maximal variability of systolic blood pressure during NE application was within 15% of the target values. Cardiac arrhythmia occurred in one patient, and intracerebral hemorrhage occurred in two patients (fatal in one and asymptomatic in the other). The authors conclude that induced arterial hypertension is feasible and safe in patients with acute stroke.