| Early computed tomography signs as early predictors of hemorrhagic transformation under heparinization in patients with cardiogenic embolism. | |
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MedLine Citation:
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PMID: 22212445 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Aim: Early computed tomography (CT) signs are crucial to predict the onset of hemorrhagic transformation (HT) and are preventive to avoid a fatal hematoma after thrombolysis. In the present study, we retrospectively reviewed the clinical records of patients receiving heparinization to investigate the correlation between early CT signs and the frequency of HT. Methods: We reviewed 96 patients with cardiogenic cerebral embolism. These patients were admitted within 24 h of the onset and were subsequently given 5000-15 000 units of heparin per day for 3 days. Owing to CT on admission, early CT changes were evaluated. Patient characteristics were also estimated, including evidence of hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease and history of smoking. The probability of hemorrhagic transformation, or good outcome and independence was assessed by backward stepwise logistic regression analysis based on the maximum likelihood ratio. Results: Higher baseline National Institutes of Health Stroke Scale (NIHSS) score, early CT signs and absence of hyperlipidemia diversely correlated with the occurrence of HT. Also, the presence or absence of early CT signs was significantly related to HT classification (χ(2) -test; P < 0.05). It was statistically significant that a higher baseline NIHSS score (OR 8.51; 95% CI 3.11-27.75) affected the outcome without showing a significant relationship to early CT signs. Conclusions: Presence of early CT signs correlated more strongly with HT than with the interval from symptom onset to hospital arrival. We might extend the therapeutic time for thrombolytic therapy, only if the early CT sign does not appear. Geriatr Gerontol Int 2011; ••: ••-••. |
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Authors:
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Takeshi Terao; Masahiro Mishina; Ichiro Takumi; Yuichi Komaba; Takayuki Mizunari; Shiro Kobayashi; Daizo Yoshida; Akira Teramoto |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-23 |
Journal Detail:
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Title: Geriatrics & gerontology international Volume: - ISSN: 1447-0594 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2012-1-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101135738 Medline TA: Geriatr Gerontol Int Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 Japan Geriatrics Society. |
Affiliation:
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Departments of Neurosurgery Neurology, Nippon Medical School Chiba-Hokusoh Hospital, Chiba The Second Department of Internal Medicine Department of Neurosurgery, Nippon Medical School, Tokyo Department of Neurosurgery, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Japan. |
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