Journal ArticleDOI
Acute stroke: usefulness of early CT findings before thrombolytic therapy.
R. von Kummer,K L Allen,Rolf Holle,Luigi Bozzao,Stefano Bastianello,Claude Manelfe,Erich Bluhmki,Peter A. Ringleb,Dieter Meier,Werner Hacke +9 more
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The response to rt-PA in patients with ischemic stroke can be predicted on the basis of initial CT findings of the extent of parenchymal hypoattenuation in the territory of the middle cerebral artery.Abstract:
PURPOSE: To determine whether the extent of subtle parenchymal hypoattenuation detected on computed tomographic (CT) scans obtained within 6 hours of ischemic stroke is a factor in predicting patients' response to thrombolytic treatment. MATERIALS AND METHODS: The baseline CT scans of 620 patients, who received either recombinant tissue plasminogen activator (rt-PA) or a placebo, in a double-blind, randomized multicenter trial were prospectively evaluated and assigned to one of three categories according to the extent of parenchymal hypoattenuation: none, 33% or less (small), or more than 33% (large) of the middle cerebral artery territory. The association between the extent of hypoattenuation on the baseline CT scans and the clinical outcome in the placebo-treated and the rt-PA-treated groups after 3 months was analyzed. RESULTS: In 215 patients with a small hypoattenuating area, treatment increased the chance of good outcome. In 336 patients with a normal CT scan and in 52 patients with a large hypoatte...read more
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Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II)
Werner Hacke,Markku Kaste,Cesare Fieschi,Rüdiger von Kummer,Antoni Dávalos,Dieter Meier,Vincent Larrue,Erich Bluhmki,Stephen M. Davis,Geoffrey A. Donnan,Dietmar Schneider,Exuperio Díez-Tejedor,Paul Trouillas +12 more
TL;DR: Despite the increased risk of intracranial haemorrhage, thrombolysis with alteplase at a dose of 0·9 mg/kg in selected patients may lead to a clinically relevant improvement in outcome.
Journal ArticleDOI
Intra-arterial Prourokinase for Acute Ischemic Stroke: The PROACT II Study: A Randomized Controlled Trial
Anthony J. Furlan,Randall T. Higashida,Lawrence R. Wechsler,Michael Gent,Howard A. Rowley,Carlos S. Kase,Michael S. Pessin,Arvind Ahuja,Fred Callahan,Wayne M. Clark,Frank L. Silver,Frank Rivera +11 more
TL;DR: Despite an increased frequency of early symptomatic intracranial hemorrhage, treatment with IA r-proUK within 6 hours of the onset of acute ischemic stroke caused by MCA occlusion significantly improved clinical outcome at 90 days.
Journal Article
Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology
Harold P. Adams,Gregory J. del Zoppo,Mark J. Alberts,Deepak L. Bhatt,Lawrence F. Brass,Anthony J. Furlan,Robert L. Grubb,Randall T. Higashida,Edward C. Jauch,Chelsea S. Kidwell,Patrick D. Lyden,Lewis B. Morgenstern,Adnan I Qureshi,Robert H. Rosenwasser,Phillip A. Scott,Eelco F. M. Wijdicks +15 more
TL;DR: The goal is to provide an overview of the current evidence about components of the evaluation and treatment of adults with acute ischemic stroke.
Journal ArticleDOI
Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists
Harold P. Adams,Gregory J. del Zoppo,Mark J. Alberts,Deepak L. Bhatt,Lawrence M. Brass,Anthony J. Furlan,Robert L. Grubb,Randall T. Higashida,Edward C. Jauch,Chelsea S. Kidwell,Patrick D. Lyden,Lewis B. Morgenstern,Adnan I. Qureshi,Robert H. Rosenwasser,Phillip A. Scott,Eelco F.M. Wijdicks +15 more
TL;DR: In this paper, the authors provide an overview of the current evidence about components of the evaluation and treatment of adults with acute ischemic stroke and provide information for healthcare policy makers.
Journal ArticleDOI
Guidelines for management of ischaemic stroke and transient ischaemic attack 2008
Peter A. Ringleb,Marie-Germaine Bousser,Gary A. Ford,Philip M.W. Bath,Michael Brainin,Valeria Caso,Álvaro Cervera,Ángel Chamorro,Charlotte Cordonnier,László Csiba,Antoni Dávalos,Hans-Christoph Diener,José M. Ferro,Werner Hacke,Michael G. Hennerici,Markku Kaste,Peter Langhorne,Kennedy R. Lees,Didier Leys,J. Lodder,Hugh S. Markus,Jean-Louis Mas,Heinrich Mattle,Keith W. Muir,Bo Norrving,Victor Obach,Stefano Paolucci,E. Bernd Ringelstein,Peter D. Schellinger,Juhani Sivenius,Skvortsova Vi,Katharina S. Sunnerhagen,Lars Thomassen,Danilo Toni,Rüdiger von Kummer,Nils Wahlgren,Marion F Walker,Joanna M. Wardlaw +37 more
TL;DR: The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.