RESUMEN
BACKGROUND: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Recent observations raised concern that IVT might cause harm in patients with strokes attributable to small artery occlusion (SAO). OBJECTIVE: The safety of IVT in SAO-patients is addressed in this study. METHODS: We used the Swiss IVT databank to compare outcome and complications of IVT-treated SAO-patients with IVT-treated patients with other etiologies (non-SAO-patients). Main outcome and complication measures were independence (modified Rankin scale
Asunto(s)
Arteriopatías Oclusivas/complicaciones , Isquemia Encefálica/etiología , Isquemia Encefálica/terapia , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/terapia , Terapia Trombolítica , Activador de Tejido Plasminógeno/uso terapéutico , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Bases de Datos Factuales , Femenino , Fibrinolíticos/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Recurrencia , Resultado del TratamientoAsunto(s)
Isquemia Encefálica/complicaciones , Isquemia Encefálica/cirugía , Enfermedades Cerebelosas/complicaciones , Enfermedades Cerebelosas/cirugía , Craneotomía/normas , Descompresión Quirúrgica/normas , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/cirugía , Anestesia , Trastornos de la Coagulación Sanguínea/tratamiento farmacológico , Infarto Cerebral/cirugía , Humanos , Infarto de la Arteria Cerebral Media/cirugía , Cuidados Posoperatorios , Factores de RiesgoRESUMEN
This databank-based, multicenter study compared all stroke patients with IV tissue plasminogen activator aged > or = 80 years (n = 38) and those < 80 years old (n = 287). Three-month mortality was higher in older patients. Favorable outcome (modified Rankin scale < or = 1) and intracranial hemorrhage (asymptomatic/symptomatic/fatal) were similarly frequent in both groups. Logistic regression showed that stroke severity, time to thrombolysis, glucose level, and history of coronary heart disease independently predicted outcome, whereas age did not.
Asunto(s)
Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/mortalidad , Terapia Trombolítica/estadística & datos numéricos , Activador de Tejido Plasminógeno/uso terapéutico , Factores de Edad , Anciano , Anciano de 80 o más Años , Glucemia/fisiología , Estudios de Cohortes , Enfermedad de la Arteria Coronaria/complicaciones , Bases de Datos Factuales , Progresión de la Enfermedad , Femenino , Humanos , Infusiones Intravenosas/normas , Infusiones Intravenosas/estadística & datos numéricos , Hemorragias Intracraneales/inducido químicamente , Hemorragias Intracraneales/epidemiología , Tiempo de Internación/estadística & datos numéricos , Masculino , Mortalidad/tendencias , Selección de Paciente , Accidente Cerebrovascular/fisiopatología , Suiza/epidemiología , Terapia Trombolítica/normas , Factores de TiempoRESUMEN
The feasibility and safety of induced arterial hypertension (10 to 20% of the initial value) in the acute phase of ischemic stroke were retrospectively evaluated in 34 patients treated with norepinephrine (NE) for a median of 26 hours. Maximal variability of systolic blood pressure during NE application was within 15% of the target values. Cardiac arrhythmia occurred in one patient, and intracerebral hemorrhage occurred in two patients (fatal in one and asymptomatic in the other). The authors conclude that induced arterial hypertension is feasible and safe in patients with acute stroke.
