ISSN: 1859 - 2872
The initial effectiveness of FLAIR-DWI mismatch guided intravenous alteplase for ischemic stroke with unknown time of onset
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Abstract
Objective: To evaluate the initial effectiveness of FLAIR-DWI mismatch guided intravenous alteplase therapy (IAT) for ischemic stroke with unknown time of onset (ISUTO). Subject and method: Descriptive, cross-sectional studies combined with longitudinal study (outcome at 90 days). 10 cases of ischemic stroke with unknown time of onset who met the criteria for intravenous alteplase therapy (IAT), clinical monitoring, mismatch FLAIR-DWI, is identified the presence of a visible ischemic lesion on diffusion- weighted imaging, combined with the absence of a clearly visible hyperintense signal in the same region on fluid-attenuated inversion recovery (FLAIR). Result: The mean of age: 70.3 ± 13.6, male to female ratio: 8/2. NIHSS score: before bolus alteplase, after 1 hour, after 24 hours and upon discharge (8.4 ± 2.6, 6.1 ± 11.6, 5.7 ± 11.8, 6.0 ± 12.7, respectively), NIHSS score decreased ≥ 4: 8/10 cases. The period of hospitalization in ISUTO group was 7.1 ± 3.9 days. Outcome at 90 days, mRS 0 - 2: 8 cases; mRS 3 - 5: 1 case, death: 1 case (due to coronary disease). Conclusion: The FLAIR-DWI guided intravenous alteplase therapy for ischemic stroke with unknown time of onset would has potential benefits.
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References
2. Mackey J (2011) Population-based study of wake-up strokes. Neurology 76(19): 1662-1667.
3. Rimmele DL and Thomalla G (2014) Wake-up stroke: Clinical characteristics, imaging findings, and treatment option - an update. Front Neurol 5: 35.
4. Thomalla G et al (2011) DWI-FLAIR mismatch for the identification of patients with acute ischaemic stroke within 4·5 h of symptom onset (PRE-FLAIR): a multicentre observational study. Lancet Neurol. 10(11): 978-986.
5. Thomalla G et al (2018) MRI-Guided thrombolysis for stroke with unknown time of onset. N Engl J Med 379(7): 611-622.
6. WHO (1988) The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): A major international collaboration. Who monica project principal investigators. Journal of Clinical Epidemiology 41(2): 105-114.
7. Nguyễn Minh Hiện (2013) Dịch tễ học đột quỵ não. Đột quỵ não, tr. 11-40.
8. Bendixen B, Wilterdink JL, Adams HP (2001) Effect of prior aspirin use on stroke severity in the trial of org 10172 in acute stroke treatment (TOAST). Stroke 32(12): 2836-2840.
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