Early Computed Tomographic Findings for Thrombolytic Therapy in Patients With Acute Brain Embolism
Early Computed Tomographic Findings for Thrombolytic Therapy in Patients With Acute Brain Embolism
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急性脑栓塞患者溶栓治疗的早期计算机断层扫描结果
DOI：
10.1161/01.str.23.1.20
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发表时间：
1992
期刊：
影响因子：
8.3
通讯作者：
M. Fujishima
中科院分区：
文献类型：
--
作者：
Y. Okada;S. Sadoshima;H. Nakane;H. Utsunomiya;M. Fujishima
背景与目的探讨急性脑栓塞溶栓治疗的疗效和安全性。方法对10例急性脑栓塞（<6 h）患者静脉注射重组组织型纤溶酶原激活剂（20-30 MU，1h），并根据CT和血管造影检查结果，对神经功能进行评价。结果4例患者在发病后24 h内症状缓解，2例患者在输注重组组织型纤溶酶原激活剂后即刻闭塞的动脉再通。在最初的计算机断层扫描（<3小时）中，4名患者已经表现出脑缺血的早期迹象，即豆状核边缘模糊，组织衰减减少或皮质沟消失。这些患者未能证明闭塞的动脉重新开放，其中一名患者发生了大量脑出血并伴有临床恶化。在其余6例患者中，2例在治疗后不久获得再通临床改善，并表现出很少或轻微的出血并发症。1个月时，5名患者的结局良好，3名患者的结局较差; 2名患者死亡。结论脑栓塞患者在发病3小时内无早期CT表现时，应用重组组织型纤溶酶原激活剂溶栓治疗是安全有效的。
Background and Purpose The benefits and safety of thrombolytic therapy was studied in patients with acute brain embolism. Methods We intravenously administered recombinant tissue plasminogen activator (20–30 MU for 1 hour) to 10 patients with acute (<6 hours) brain embolism and examined the neurological outcomes in relation to the findings on computed tomography and angiography. Results The symptoms ameliorated in four patients within 24 hours after onset, and reopening of the occluded arteries occurred in two of the patients immediately after recombinant tissue plasminogen activator infusion. On the initial computed tomographic scan (<3 hours), four patients had already demonstrated early indications of brain ischemia, that is, an obscure margin of the lentiform nuclei, reduced tissue attenuation, or effacement of cortical sulci. These patients failed to demonstrate reopening of the occluded arteries, and one developed a massive brain hemorrhage with clinical deterioration. Of the remaining six patients, two obtained clinical improvement with recanalization soon after the therapy and demonstrated little to slight hemorrhagic complications. The outcomes at 1 month were favorable in five patients and poor in three; death occurred in two. Conclusions Thrombolytic therapy with recombinant tissue plasminogen activator may be safe and effective when there are no early computed tomographic findings within 3 hours from the onset of embolic stroke.
影响因子：
8.3
作者：
G. Zoppo;B. Copeland;James A. Koziol
通讯作者：
G. Zoppo;B. Copeland;James A. Koziol