Safety of thrombolysis in stroke mimics: results from a multicenter cohort study.

Abstract:

BACKGROUND AND PURPOSE:Intravenous thrombolysis for acute ischemic stroke is beneficial within 4.5 hours of symptom onset, but the effect rapidly decreases over time, necessitating quick diagnostic in-hospital work-up. Initial time strain occasionally results in treatment of patients with an alternate diagnosis (stroke mimics). We investigated whether intravenous thrombolysis is safe in these patients. METHODS:In this multicenter observational cohort study containing 5581 consecutive patients treated with intravenous thrombolysis, we determined the frequency and the clinical characteristics of stroke mimics. For safety, we compared the symptomatic intracranial hemorrhage (European Cooperative Acute Stroke Study II [ECASS-II] definition) rate of stroke mimics with ischemic strokes. RESULTS:One hundred stroke mimics were identified, resulting in a frequency of 1.8% (95% confidence interval, 1.5-2.2). Patients with a stroke mimic were younger, more often female, and had fewer risk factors except smoking and previous stroke or transient ischemic attack. The symptomatic intracranial hemorrhage rate in stroke mimics was 1.0% (95% confidence interval, 0.0-5.0) compared with 7.9% (95% confidence interval, 7.2-8.7) in ischemic strokes. CONCLUSIONS:In experienced stroke centers, among patients treated with intravenous thrombolysis, only a few had a final diagnosis other than stroke. The complication rate in these stroke mimics was low.

journal_name

Stroke

journal_title

Stroke

authors

Zinkstok SM,Engelter ST,Gensicke H,Lyrer PA,Ringleb PA,Artto V,Putaala J,Haapaniemi E,Tatlisumak T,Chen Y,Leys D,Sarikaya H,Michel P,Odier C,Berrouschot J,Arnold M,Heldner MR,Zini A,Fioravanti V,Padjen V,Beslac-Bu

doi

10.1161/STROKEAHA.111.000126

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

1080-4

issue

4

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.111.000126

journal_volume

44

pub_type

杂志文章,多中心研究

相关文献

STROKE文献大全
  • A new method for quantitative regional cerebral blood volume measurements using computed tomography.

    abstract:BACKGROUND AND PURPOSE:Knowledge of cerebral blood volume (CBV) is invaluable in identifying the primary cause of brain swelling in patients with stroke or severe head injury, and it might also help in clinical decision making in patients thought to have hemodynamic transient ischemic attacks (TIAs). This investigation...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.10.1998

    authors: Muizelaar JP,Fatouros PP,Schröder ML

    更新日期:1997-10-01 00:00:00

  • Cerebral pathophysiology in hemorrhagic shock. Nuclide scan data, fluorescence microscopy, and anatomic correlations.

    abstract::Nineteen unanesthetized sheep were given Evans blue dye or radionuclide and then were incrementally bled into hemorrhagic shock (BP less than 50/25) by withdrawal of blood over a period of approximately one hour. Four sheep served as controls for histologic data. Static nuclide brain scans performed in 6 bled sheep d...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.11.1.50

    authors: Bronshvag MM

    更新日期:1980-01-01 00:00:00

  • Low carotid calcium score is associated with higher levels of glycosaminoglycans, tumor necrosis factor-alpha, and parathyroid hormone in human carotid plaques.

    abstract:BACKGROUND AND PURPOSE:Computed tomography (CT) is used to study coronary artery plaques, but little is known about its potential to characterize plaque composition. This study assesses the relation between carotid calcium score (CCS) by CT and plaque composition, namely extracellular matrix, inflammatory mediators, an...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.620658

    authors: Edsfeldt A,Dias N,Elmståhl B,Müller MF,Berg K,Nitulescu M,Persson A,Ekberg O,Gonçalves I

    更新日期:2011-10-01 00:00:00

  • The risk of stroke or clinical impairment after stereotactic radiosurgery for ARUBA-eligible patients.

    abstract:BACKGROUND AND PURPOSE:The best management of patients with unruptured brain arteriovenous malformations (BAVM) is controversial. In this study, we analyzed the stroke rate and functional outcomes of patients having stereotactic radiosurgery (SRS) for unruptured BAVM using the same eligibility criteria and primary end ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.112.670232

    authors: Pollock BE,Link MJ,Brown RD

    更新日期:2013-02-01 00:00:00

  • Should decompressive surgery be performed in malignant cerebral venous thrombosis?: a series of 12 patients.

    abstract:BACKGROUND AND PURPOSE:In malignant cerebral venous thrombosis (CVT) patients, emergency decompressive surgery has been suggested as a life-saving procedure. We report 12 patients with malignant CVT, among whom 8 underwent operation. METHODS:Retrospective study of 12 patients from 3 stroke units who had a malignant CV...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.572909

    authors: Théaudin M,Crassard I,Bresson D,Saliou G,Favrole P,Vahedi K,Denier C,Bousser MG

    更新日期:2010-04-01 00:00:00

  • Stroke Risk and Mortality in Patients With Ventricular Assist Devices.

    abstract:BACKGROUND AND PURPOSE:Ventricular assist devices (VADs) have advanced the management of end-stage heart failure. However, these devices are associated with hemorrhagic and thrombotic complications, including stroke. We assessed the incidence, risk factors, and outcomes of ischemic and hemorrhagic stroke after VAD plac...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.116.014049

    authors: Parikh NS,Cool J,Karas MG,Boehme AK,Kamel H

    更新日期:2016-11-01 00:00:00

  • Changes in locomotor activity and passive avoidance task performance induced by cerebral ischemia in Mongolian gerbils.

    abstract:BACKGROUND AND PURPOSE:We investigated changes in locomotor activity, passive avoidance task performance, and hippocampal CA1 neurons induced by cerebral ischemia in Mongolian gerbils to examine the relation between these behavioral changes and CA1 neuronal damage. METHODS:Spontaneous locomotor activity was measured u...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.3.645

    authors: Karasawa Y,Araki H,Otomo S

    更新日期:1994-03-01 00:00:00

  • The Virtual International Stroke Trials Archive.

    abstract:BACKGROUND AND PURPOSE:Stroke has global importance and it causes an increasing amount of human suffering and economic burden, but its management is far from optimal. The unsuccessful outcome of several research programs highlights the need for reliable data on which to plan future clinical trials. The Virtual Internat...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.106.473579

    authors: Ali M,Bath PM,Curram J,Davis SM,Diener HC,Donnan GA,Fisher M,Gregson BA,Grotta J,Hacke W,Hennerici MG,Hommel M,Kaste M,Marler JR,Sacco RL,Teal P,Wahlgren NG,Warach S,Weir CJ,Lees KR

    更新日期:2007-06-01 00:00:00

  • Diffusion and perfusion magnetic resonance imaging studies to evaluate a noncompetitive N-methyl-D-aspartate antagonist and reperfusion in experimental stroke in rats.

    abstract:BACKGROUND AND PURPOSE:Diffusion magnetic resonance imaging (MRI) can quantitatively detect focal ischemic injury within minutes of onset, and perfusion MRI can evaluate the brain's microcirculation. N-Methyl-D-aspartate (NMDA) antagonists and reperfusion can reduce lesion size in stroke models. We used diffusion and p...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.24.12.2074

    authors: Minematsu K,Fisher M,Li L,Sotak CH

    更新日期:1993-12-01 00:00:00

  • Cerebral mast cells mediate blood-brain barrier disruption in acute experimental ischemic stroke through perivascular gelatinase activation.

    abstract:BACKGROUND AND PURPOSE:Perivascularly positioned cerebral mast cells (MC) have been shown to participate in acute blood-brain barrier disruption and expansive brain edema following experimental transient cerebral ischemia. However, the underlying molecular mechanisms remain unknown. Because proteolytic gelatinase enzym...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.632224

    authors: Mattila OS,Strbian D,Saksi J,Pikkarainen TO,Rantanen V,Tatlisumak T,Lindsberg PJ

    更新日期:2011-12-01 00:00:00

  • Early component changes in corticomotor evoked potentials following experimental stroke.

    abstract::Corticomotor evoked potentials have recently been used in experimental animals and patients as a measure of neurologic function after stroke. However, little is known about the fundamental electrophysiologic properties contributing to the formation of these potentials. To define some of these properties, corticomotor ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.6.1141

    authors: Simpson RK Jr,Baskin DS

    更新日期:1987-11-01 00:00:00

  • Interrater agreement in evaluation of stroke patients with the unified neurological stroke scale.

    abstract:BACKGROUND:We sought to determine interrater agreement in evaluation of stroke patients with the Unified Form for Neurological Stroke Scales (UFNSS). SUMMARY OF REPORT:Fifty inpatients were independently examined by three neurologists. Kendall coefficients of concordance were computed for the different items of the UF...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.6.1263

    authors: Treves TA,Karepov VG,Aronovich BD,Gorbulev AY,Bornstein NM,Korczyn AD

    更新日期:1994-06-01 00:00:00

  • Ischemic stroke during sleep: its association with worse early functional outcome.

    abstract:BACKGROUND AND PURPOSE:Approximately one fourth of stroke occur during sleep. Despite the clinical and radiological similarities between wake-up stroke (WUS) and non-WUS, the functional outcomes of WUS are largely unknown. METHODS:This retrospective analysis reviewed 2289 consecutive patients with acute ischemic strok...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.602243

    authors: Kim BJ,Lee SH,Shin CW,Ryu WS,Kim CK,Yoon BW

    更新日期:2011-07-01 00:00:00

  • Fibrinogen independently predicts the development of ischemic stroke in a Taiwanese population: CVDFACTS study.

    abstract:BACKGROUND AND PURPOSE:Of few prospective studies that have focused on the relationship between fibrinogen and ischemic stroke (IS) in Asian populations, the findings were inconsistent with those conducted in Western countries. Therefore, we aimed to investigate the temporal relationship between fibrinogen levels (plus...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.540492

    authors: Chuang SY,Bai CH,Chen WH,Lien LM,Pan WH

    更新日期:2009-05-01 00:00:00

  • Effects of hypothermia on evoked potentials, magnetic resonance imaging, and blood flow in focal ischemia in rabbits.

    abstract:BACKGROUND AND PURPOSE:Mild hypothermia has been shown to ameliorate neuronal damage due to cerebral ischemia. In our study, the influence of mild-to-moderate hypothermia was examined in a rabbit model of focal cerebral ischemia. METHODS:After 4 hours of permanent ischemia induced by occlusion of the anterior and midd...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.6.889

    authors: Lo EH,Steinberg GK

    更新日期:1992-06-01 00:00:00

  • Optogenetic Inhibition of Striatal GABAergic Neuronal Activity Improves Outcomes After Ischemic Brain Injury.

    abstract:BACKGROUND AND PURPOSE:Striatal GABAergic neuron is known as a key regulator in adult neurogenesis. However, the specific role of striatal GABAergic neuronal activity in the promotion of neurological recovery after ischemic stroke remains unknown. Here, we used optogenetic approach to investigate these effects and mech...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.117.019017

    authors: Jiang L,Li W,Mamtilahun M,Song Y,Ma Y,Qu M,Lu Y,He X,Zheng J,Fu Z,Zhang Z,Yang GY,Wang Y

    更新日期:2017-12-01 00:00:00

  • Impact of pretreatment noncontrast CT Alberta Stroke Program Early CT Score on clinical outcome after intra-arterial stroke therapy.

    abstract:BACKGROUND AND PURPOSE:The efficacy of intra-arterial treatment remains uncertain. Because most centers performing IAT use noncontrast CT (NCCT) imaging, it is critical to understand the impact of NCCT findings on treatment outcomes. This study aimed to compare functional independence and safety among patients undergoi...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.113.004260

    authors: Yoo AJ,Zaidat OO,Chaudhry ZA,Berkhemer OA,González RG,Goyal M,Demchuk AM,Menon BK,Mualem E,Ueda D,Buell H,Sit SP,Bose A,Penumbra Pivotal and Penumbra Imaging Collaborative Study (PICS) Investigators.

    更新日期:2014-03-01 00:00:00

  • Central conduction time in primate brain ischemia -- a study in baboons.

    abstract::The relationship between central conduction time (CCT) and levels of regional blood flow were studied in 9 primates. Flows were recorded in both hemispheres using the method of hydrogen (2 min) clearance. The somatosensory evoked potentials were recorded over the contralateral cortex and the dorsal columns, following ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.11.6.637

    authors: Hargadine JR,Branston NM,Symon L

    更新日期:1980-11-01 00:00:00

  • Lamotrigine protects hippocampal CA1 neurons from ischemic damage after cardiac arrest.

    abstract:BACKGROUND AND PURPOSE:Lamotrigine (LTG) is an anticonvulsant drug whose mechanism of action may involve the inhibition of glutamate release by blocking voltage-dependent sodium channels. Glutamate neurotoxicity may contribute to cerebral ischemic damage after recovery from cardiac arrest. Thus, LTG may prevent the bra...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.11.2230

    authors: Crumrine RC,Bergstrand K,Cooper AT,Faison WL,Cooper BR

    更新日期:1997-11-01 00:00:00

  • Mechanism of ATP-induced [Ca(2+)](i) mobilization in rat basilar smooth muscle cells.

    abstract:BACKGROUND AND PURPOSE:We have previously reported that extracellular ATP activates P(2u) receptors and increases intracellular free Ca(2+) ([Ca(2+)](i)) by G protein/phospholipase C/inositol 1,4,5-triphosphate pathways in cerebral artery smooth muscle cells. However, the possible contribution of other signaling pathwa...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.31.6.1377

    authors: Aoki K,Zubkov AY,Parent AD,Zhang JH

    更新日期:2000-06-01 00:00:00

  • Evidence for platelet-activating factor as a novel mediator in experimental stroke in rabbits.

    abstract::Platelet-activating factor is a potent mediator of inflammation, which has untoward effects on cerebrovascular and neural elements. While several investigators have reported attenuation of ischemic damage after treatment with antagonists of platelet-activating factor, no study has proved endogenous production of plate...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.21.10.1452

    authors: Lindsberg PJ,Yue TL,Frerichs KU,Hallenbeck JM,Feuerstein G

    更新日期:1990-10-01 00:00:00

  • Restriction fragment length polymorphism of the apoprotein A-I-C-III gene cluster in control and stroke-prone white and black subjects: racial differences.

    abstract:BACKGROUND AND PURPOSE:The presence of known restriction fragment length polymorphisms in the apoprotein A-I-C-III gene cluster, which encodes their respective apoproteins, was investigated using the restriction enzymes Sac I and Pst I to determine the potential role of genetic variations for stroke risk in an American...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.9.1257

    authors: Kasturi R,Yatsu FM,Alam R,Rogers S

    更新日期:1992-09-01 00:00:00

  • Neurological deficit and extent of neuronal necrosis attributable to middle cerebral artery occlusion in rats. Statistical validation.

    abstract:BACKGROUND AND PURPOSE:Occluding a large intracranial artery in rats produces a brain lesion that grows in terms of an increase in both surface area and number of necrotic neurons. The present study investigated whether reperfusing the ischemic territory 30 to 60 minutes after the arterial occlusion would have a benefi...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.4.627

    authors: Garcia JH,Wagner S,Liu KF,Hu XJ

    更新日期:1995-04-01 00:00:00

  • Therapeutic hypothermia for brain ischemia: where have we come and where do we go?

    abstract::Mild hypothermia is an established neuroprotectant in the laboratory, showing remarkable and consistent effects across multiple laboratories and models of brain injury. At the clinical level, mild hypothermia has shown benefits in patients who have experienced cardiac arrest and in some pediatric populations experienc...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/STROKEAHA.110.595371

    authors: Yenari MA,Hemmen TM

    更新日期:2010-10-01 00:00:00

  • 4G/4G genotype of PAI-1 gene is associated with reduced risk of stroke in elderly.

    abstract:BACKGROUND AND PURPOSE:Plasminogen activator inhibitor type 1 (PAI-1) is the main inhibitor of fibrinolysis, and high levels may increase the risk of cardiovascular disease. The 4G/5G polymorphism affects PAI-1 gene transcription with lower levels of plasma PAI-1 in the presence of the 5G allele. We investigated whethe...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000098004.26252.EB

    authors: Hoekstra T,Geleijnse JM,Kluft C,Giltay EJ,Kok FJ,Schouten EG

    更新日期:2003-12-01 00:00:00

  • Socioeconomic differences in quality of care and clinical outcome after stroke: a nationwide population-based study.

    abstract:BACKGROUND AND PURPOSE:The association among socioeconomic status, quality of care, and clinical outcome after stroke remains poorly understood. In a Danish nationwide follow-up study, we examined whether socioeconomic-related differences in acute stroke care occur and, if so, whether they explain socioeconomic differe...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.611871

    authors: Langagergaard V,Palnum KH,Mehnert F,Ingeman A,Krogh BR,Bartels P,Johnsen SP

    更新日期:2011-10-01 00:00:00

  • Structure of plaque at carotid bifurcation: high-resolution MRI with histological correlation.

    abstract:BACKGROUND AND PURPOSE:The composition of carotid atherosclerosis was visualized by using 3D MRI at high resolution with 200-micrometer (3) voxels. Magnetic resonance signal characteristics were correlated with plaque components, including collagenous cap, necrotic core, and calcification, to define resolution and othe...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/hs1101.098663

    authors: Coombs BD,Rapp JH,Ursell PC,Reilly LM,Saloner D

    更新日期:2001-11-01 00:00:00

  • Relation between cerebral perfusion territories and location of cerebral infarcts.

    abstract:BACKGROUND AND PURPOSE:The perfusion territories of the brain-feeding arteries are difficult to assess in vivo and therefore standard cerebral perfusion territory templates are often used to determine the relation between cerebral infarcts and the feeding vasculature. In the present study, we compared this infarct clas...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.539866

    authors: Hendrikse J,Petersen ET,Chèze A,Chng SM,Venketasubramanian N,Golay X

    更新日期:2009-05-01 00:00:00

  • Flow patterns in the human carotid artery bifurcation.

    abstract::To elucidate the connection between blood flow and the localized genesis and development of atherosclerosis and thrombosis at the human carotid artery bifurcation, detailed studies of the flow patterns and distributions of fluid velocity and wall shear rate in this region were carried out using a transparent segment o...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.15.1.50

    authors: Motomiya M,Karino T

    更新日期:1984-01-01 00:00:00

  • Cerebral blood flow and ischemia-induced neurotransmitter release in the striatum of aged spontaneously hypertensive rats.

    abstract:BACKGROUND AND PURPOSE:We found age-related vulnerability to cerebral ischemia in the hippocampus and striatum in spontaneously hypertensive rats. Further study revealed that ischemia-induced release of hippocampal taurine, an inhibitory amino acid, was reduced by 40% in aged rats compared with adult rats, which sugges...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.24.4.577

    authors: Yao H,Ooboshi H,Ibayashi S,Uchimura H,Fujishima M

    更新日期:1993-04-01 00:00:00