Good outcomes in ischemic stroke patients treated with intravenous thrombolysis despite regressing neurological symptoms

• Published in: Stroke (1970) Vol. 37; no. 5; pp. 1332 - 1333
• Main Authors: BAUMANN, Christian R, BAUMGARTNER, Ralf W, GANDJOUR, Joubin, VON BÜDINGEN, Hans-Christian, SIEGEL, Adrian M, GEORGIADIS, Dimitrios
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.05.2006
• Subjects: Adult; Aged; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Pharmacology. Drug treatments; Retrospective Studies; Stroke - drug therapy; Stroke - physiopathology; Thrombolytic Therapy; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; Human; Cerebral infarction; Stroke; Nervous system diseases; Prognosis; Intravenous administration; Cardiovascular disease; cerebrovascular disorder; Cerebral disorder; Vascular disease; Treatment; Central nervous system disease; thrombolysis; Neurological disorder; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.0000217272.38455.a2

We evaluated the clinical course of 19 acute stroke patients with rapid early improvement of neurological deficit within the 3-hour window, treated with intravenous thrombolytics. No patient demonstrated a neurological deterioration during hospitalization. National Institutes of Health Stroke Scale (NIHSS) scores at therapy decision and discharge were 5 (4 to 6) and 0.5 (0 to 1.5), respectively. At 3-month follow-up, 1 patient had died; in remaining patients, NIHSS was 0 (0 to 1) and modified Rankin Scale 0.5 (0 to 1; < or =1 in 15 patients). Withholding of intravenous thrombolysis because of spontaneous early regression of neurological symptoms may not be justified.