| Long-term follow up of patients with good outcome after intra-arterial thrombolysis for major arterial occlusion in the carotid territory: clinical and magnetic resonance imaging evaluation. | |
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MedLine Citation:
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PMID: 20098019 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Long-term clinical symptoms, including extrapyramidal signs, and magnetic resonance (MR) imaging studies were retrospectively analyzed in 21 patients with good outcome (modified Rankin scale scores 0-2) after successful recanalization of occluded major arteries by intra-arterial thrombolysis with mechanical disruption. Changes in high intensity areas (HIAs) and cerebral atrophy in the ischemic hemisphere were evaluated on follow-up fluid-attenuated inversion recovery MR images. Extrapyramidal signs, short-stepped gait and/or masked face, were observed in 12 of 21 patients during the follow-up period (11 to 68 months, mean 42 months). Enlargement of HIA was demonstrated in 10 of 18 patients undergoing follow-up MR imaging. Cerebral atrophy in the ischemic hemisphere was revealed on the follow-up MR images in all 18 patients. In nine patients with small infarctions, 20 ml or less on computed tomography scans, cerebral atrophy progressed more rapidly in four patients with extrapyramidal signs compared to the other five patients without extrapyramidal signs (p < 0.05). More than half of the patients with good outcome showed extrapyramidal signs. Extrapyramidal signs in patients with small infarction may indicate rapid progression of cerebral atrophy. The occurrence of extrapyramidal signs might be related to delayed neuronal death in atrophic areas. |
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Authors:
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Takatoshi Sorimachi; Yasushi Ito; Kenichi Morita; Yukihiko Fujii |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurologia medico-chirurgica Volume: 50 ISSN: 1349-8029 ISO Abbreviation: Neurol. Med. Chir. (Tokyo) Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-25 Completed Date: 2010-05-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0400775 Medline TA: Neurol Med Chir (Tokyo) Country: Japan |
Other Details:
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Languages: eng Pagination: 13-9; discussion 19 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Nishiogi-chuo Hospital, Tokyo, Japan. sorimachi-t@h2.dion.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Atrophy / etiology, pathology Brain / blood supply, pathology*, physiopathology Carotid Stenosis / complications, drug therapy* Cerebrum / blood supply, pathology, physiopathology Disability Evaluation Female Fibrinolytic Agents / administration & dosage* Follow-Up Studies Humans Infusions, Intra-Arterial / statistics & numerical data Longitudinal Studies Magnetic Resonance Imaging Male Middle Aged Muscle Rigidity / etiology, physiopathology Nerve Degeneration / etiology, pathology, physiopathology Outcome Assessment (Health Care) / methods Retrospective Studies Severity of Illness Index Stroke / drug therapy*, etiology, pathology* Thrombolytic Therapy / methods*, statistics & numerical data Tomography, X-Ray Computed Urokinase-Type Plasminogen Activator / administration & dosage Vascular Surgical Procedures / instrumentation, methods |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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