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Thrombolysis as a factor associated with favorable outcomes in patients with unclear-onset stroke.
MedLine Citation:
PMID:  21299733     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background and purpose:  Clinical and radiological features of patients with unclear-onset stroke do not differ significantly from those with known-onset stroke. There is a lack of evidence for the safety and efficacy of thrombolysis in patients with unclear-onset stroke. We sought to provide supportive data on the safety and efficiency of thrombolysis in patients with unclear-onset stroke. Methods:  We retrospectively identified patients with unclear-onset stroke (<3 h of first found abnormal time) from our stroke registry. We performed following protocols for thrombolysis in patients with unclear-onset stroke; initial conventional CT-based intravenous thrombolysis (IVT), repeat MRI during IVT, and then decision to maintain IVT or to perform combined intra-arterial thrombolysis. In addition, we compared clinical outcomes and safety between thrombolyzed and non-thrombolyzed patients. Results:  A total of 78 patients with unclear-onset stroke were included. Twenty-nine patients underwent thrombolysis. Thrombolysis (OR, 6.842; 95% CI, 1.950-24.004; P = 0.003) and baseline NIHSS (OR, 0.769; 95% CI, 0.645-0.917; P = 0.003) were associated with favorable outcomes at 3 months in multivariate logistic regression analysis. The frequency of hemorrhagic transformation and symptomatic ICH was not significantly different between the thrombolyzed and non-thrombolyzed patients (34.4% vs. 40.7% and 10.3% vs. 8.2%, respectively). Conclusion:  The results of this study suggest that thrombolysis in unclear-onset stroke could be independently associated with favorable outcomes at 3 months and that thrombolysis based on repeat imaging appears to be safely applied to patients with unclear-onset stroke.
Authors:
J-T Kim; M-S Park; T-S Nam; S-M Choi; B-C Kim; M-K Kim; K-H Cho
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-8
Journal Detail:
Title:  European journal of neurology : the official journal of the European Federation of Neurological Societies     Volume:  -     ISSN:  1468-1331     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9506311     Medline TA:  Eur J Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Author(s). European Journal of Neurology © 2011 EFNS.
Affiliation:
 Department of Neurology, Chonnam National University Medical School, Gwangju  Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
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