Document Detail


Factors affecting the angiographic recanalization and early clinical improvement in middle cerebral artery territory infarction after thrombolysis.
MedLine Citation:
PMID:  15534179     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Factors affecting the angiographic recanalization (AR) and clinical improvement (CI) still remain unclear in patients receiving thrombolytic therapy. OBJECTIVES: To elucidate factors related to AR and early CI in patients with middle cerebral artery (MCA) or internal carotid artery (ICA) occlusion. DESIGNS: Retrospective study. SETTING: Department of Neurology, Asan Medical Center, Seoul, South Korea. PATIENTS: We studied 42 patients who (1) underwent diffusion-weighted magnetic resonance (MR) imaging and MR angiography within 6 hours after onset, (2) had MCA territory infarction, (3) had nonvisualization of the MCA or the ICA on initial MR angiography, (4) were treated with thrombolytics, and (5) underwent follow-up MR imaging and MR angiography at day 2 or 3. RESULTS: Successful AR and CI were achieved in 31 and 16 patients, respectively. Angiographic recanalization was related to CI (P<.01), lower follow-up National Institutes of Health Stroke Scale scores (P<.05), the absence of a dominant ipsilateral posterior cerebral artery (P<.01) on initial MR angiography, and the sparing of the internal capsule on both initial (P<.05) and follow-up (P<.01) MR imaging. Clinical improvement was associated with the absence of ICA (vs MCA) flow signals (P<.05), the sparing of the internal capsule (P<.01), and marginally, with the infarct volume change (P = .06). CONCLUSIONS: In patients with MCA or ICA occlusion, CI after thrombolysis is related to the AR and the sparing of the critical motor pathway. The presence of a dominant ipsilateral posterior cerebral artery may predict poor AR after thrombolysis.
Authors:
Jee-Hyun Kwon; Sun U Kwon; Ju H Lee; Choong G Choi; Dae C Suh; Jong S Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  61     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-09     Completed Date:  2004-12-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1682-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology and Radiology, Asan Medical Center, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Artery Diseases / drug therapy*
Cerebral Infarction / drug therapy*,  therapy*
Cerebrovascular Circulation
Female
Fibrinolytic Agents / therapeutic use*
Health Status
Humans
Infarction, Middle Cerebral Artery / drug therapy*
Magnetic Resonance Angiography*
Male
Middle Aged
Prognosis
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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