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The clinical profile and treatment outcome of acute ischemic stroke patients who underwent thrombolysis with recombinant tissue plasminogen activator therapy: St. Luke's medical center experience (a retrospective study).

Author

Ross Allan M.  Mendoza,
Ma. Cristina Z. San Jose

Related Institution

Section of Adult Neurology, International Institute for Neurosciences - St. Luke's Medical Center

Publication Information

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
The Philippine Journal of Neurology
Frequency
Quarterly
Publication Date
November 2009
Volume
13
Issue
2
Page(s)
21-28

Abstract

BACKGROUND: Recombinant Tissue Plasminogen Activator therapy has been recommended as the standard treatment for acute ischemic stroke. The experience in the Philippines is still limited.


OBJECTIVE: We evaluated the clinical profile and outcome of our acute ischemic stroke patients who underwent thrombolysis.


PATIENTS AND METHODS: Ten cases from a retrospectively collected database of patients with acute ischemic stroke who presented within 3 hours of onset were screened under the Brain Attack Team Program. Those eligible were treated with thrombolysis with recombinant tissue plasminogen activator (rt-PA) at 0.9 mg/kg, and or bridging therapy with intravenous and intra-arterial for those beyond the therapeutic window. General and neurological examinations together with the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) were recorded prior to and after the treatment at 1 hour, 24 hour, on discharge. Hemorrhagic brain lesion and death within discharge were also recorded.


RESULTS: The mean pretreatment NIHSS score was 18 and most of the patients had anterior circulation infarction. The mean door-to-treatment time was 170 min (ranged 60-400 min). intracerebral hemorrhage was detected in three cases, and one was fatal.


CONCLUSION: Thrombolytic therapy can be given in patients with acute stroke without down -titrating the dose in our population. The risk of hemorrhagic brain lesion is not much higher compared to other studies.


 


 
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