Posterior circulation stroke is associated with prolonged door-to-needle time
Posterior circulation stroke is associated with prolonged door-to-needle time
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DOI：
10.1111/j.1747-4949.2012.00952.x
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发表时间：
2015-07-01
影响因子：
6.7
通讯作者：
Savitz, Sean I.
中科院分区：
文献类型：
--
作者：
Sarraj, Amrou;Medrek, Sarah;Savitz, Sean I.
缺乏对急性后循环缺血性卒中早期症状的认识，可能会延误组织纤溶酶原激活剂的及时诊断和治疗。目的与假设我们假设与前循环卒中相比，后循环卒中患者接受延迟溶栓治疗。我们调查了前循环缺血性卒中患者和后循环卒中患者在评估或治疗时间上的差异，目的是了解可能导致这些延迟的障碍。方法采用横断面研究，研究对象是连续来到三级学术中心的急性缺血性卒中患者，他们在症状出现后45h内接受了静脉注射组织型纤溶酶原激活剂。我们比较了前循环卒中和后循环卒中患者的人口学、卒中严重程度、症状和体征，以及发病、急诊到达、急诊医生评估、神经科医生评估、脑成像和组织纤溶酶原激活剂治疗之间的时间间隔。结果在252例接受静脉注射组织纤溶酶原激活剂治疗的患者中，12%发生后循环卒中。后循环卒中患者的美国国立卫生研究院卒中量表(NIHSS)评分中位数低于对照组(P=001)，恶心发生率高于对照组(P<0.01)。
BackgroundLack of recognition of early symptoms of acute posterior circulation ischaemic stroke might delay timely diagnosis and treatment with tissue plasminogen activator.Aims and hypothesisWe hypothesized that patients with posterior circulation stroke receive delayed thrombolytic treatment in comparison to anterior circulation stroke. We investigated the differences in times to evaluation or treatment between patients with anterior circulation ischaemic stroke and posterior circulation stroke in our aim to understand the barriers that might have caused these delays.MethodsA cross-sectional study was conducted using consecutive patients presenting to our tertiary academic centre with acute ischaemic stroke who were treated with intravenous tissue plasminogen activator within 45h from symptom onset. We compared demographics, stroke severity, symptoms and signs, and time intervals among onset, emergency department arrival, emergency department physician evaluation, neurologist evaluation, brain imaging, and tissue plasminogen activator treatment in patients with anterior circulation stroke and posterior circulation stroke.ResultsAmong 252 patients treated with intravenous tissue plasminogen activator, 12% had posterior circulation stroke. Patients with posterior circulation stroke had significantly lower median baseline the National Institutes of Health and Stroke Scale (NIHSS) score (P=001), higher frequency of nausea (P