Performance Rate of Thrombolytic Therapy and Acute Prognosis of Hyperacute Ischemic Stroke

J Korean Neurol Assoc > Volume 19(5); 2001 > Article

Journal of the Korean Neurological Association 2001;19(5): 447-451.

"초급성 허혈성 뇌졸중 환자에서 혈전용해술 시행 빈도 및 예후"

최성호, 나정호 ·김미라 ·하충건

인하대학교 의과대학 신경과학교실

Performance Rate of Thrombolytic Therapy and Acute Prognosis of Hyperacute Ischemic Stroke

Seong-Ho Choi, M.D., Joung-Ho Rha, M.D., Mira Kim, M.D., Choong-Kun Ha, M.D.

Department of Neurology, Inha University Medical College, Inchon, Korea

Abstract

"Background : Tissue plasminogen activator (tPA) is known to be effective if given within 3 hours after the onset of ischemic stroke. However, no study has been performed regarding what proportion of patients with acute ischemic stroke are actually given tPA within this time window. We therefore tried to figure out the performance rate of thrombolytic therapy and acute prognosis in hyperacute ischemic stroke patients. M e t h o d s : We prospectively registered all the acute ischemic stroke patients. Thrombolyic therapy was decided strictly according to the NINDS tPA protocol and clinical monitoring was done by the NIH Stroke Scale (NIHSS). If tPA was not given, the reason was recorded. R e s u l t s : Among 613 acute stroke patients during a period of 2.5 years, there were 146 (23.8%) hyperacute ischemic stroke patients within 3 hours after onset. Even in the 29 cases of in-hospital stroke, the rate of early detection and management was only 27.6% (8 cases). Among the hyperacute stroke population, 56 (38.4%) patients were treated with the thrombolytic agent and 27 patients showed positive responses. Thrombolytic therapy was not tried in the remaining 90 patients. The most common reason was expectation of favorable outcome without thrombolysis. But among these patients, subsequent neu-rological worsening was noticed in 9 patients, particularly in those with vertebrobasilar stroke. C o n c l u s I o n s : Urgent notice and management of ischemic stroke needs to be more emphasized not only to the general public, but also to med-ical personnel. More close observation is especially needed in vertebrobasilar stroke cases J Korean Neurol Assoc 19(5):447~451, 2001 Key Words : Hyperacute stroke, Prognosis, Thrombolytic therapy"