Key result
Among patients receiving intravenous tPA for suspected cerebral ischemia, 12.6% did not develop ischemic injury, including 9.1% diagnosed with TIA and 3.5% with a nonischemic stroke mimic.
Why the study?
What is the frequency of normal imaging (stroke mimic or TIA) in patients receiving intravenous tPA for suspected acute ischemic stroke?
Observational (n=254)
Yes
What is the frequency of normal imaging (stroke mimic or TIA) in patients receiving intravenous tPA for suspected acute ischemic stroke?
Over 10% of patients treated with intravenous tPA for suspected cerebral ischemia do not develop ischemic injury, highlighting the occurrence of tPA administration for stroke mimics and TIAs.
Over 10% of tPA recipients may avoid ischemic injury; leaves open optimal selection criteria for future prospective validation.
BACKGROUND: The frequency with which intravenous thrombolysis for acute ischemic stroke results in normal clinical and radiographic status is currently unknown. METHODS: Patients who received intravenous thrombolysis at community hospitals and a stroke center were retrospectively analyzed for occurrence of normal imaging after tissue plasminogen activator (tPA) treatment. The cases were classified as nonischemic process (stroke mimic), transient ischemic attack (TIA) or ischemic stroke. The occurrence rate and predictors of each condition were sought. RESULTS: Of 254 patients who received tPA, 9 (3.5%) had a nonischemic process, 23 (9.1%) had TIA, and 222 (87%) were diagnosed with ischemic stroke. Nonischemic process patients were younger and were more likely to have received tPA at a community hospital than those with TIA or stroke. TIA was associated with lower pretreatment serum glucose, prevalence of coronary artery disease and stroke severity but not to time to treatment. CONCLUSION: Over 10% of patients who receive tPA for cerebral ischemia do not develop ischemic injury. tPA use for a nonischemic process is infrequent but is associated with community hospital use.
No takes yet. Share an insight, caveat, or question.
Uchino et al. (2009) conducted an observational in acute ischemic stroke (n=254). intravenous tissue plasminogen activator (tPA) was evaluated on occurrence of normal imaging (classified as nonischemic process, TIA, or ischemic stroke). Among patients receiving intravenous tPA for suspected cerebral ischemia, 12.6% did not develop ischemic injury, including 9.1% diagnosed with TIA and 3.5% with a nonischemic stroke mimic.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: