Thrombolytic therapy in stroke-related trauma.
OBJECTIVE
Trauma and/or evidence of nonintracranial bleeding is a relative contraindication for thrombolytic therapy in acute stroke. The aim of this study was to determine the incidence and nature of stroke-related trauma and its influence on treatment of patients.


METHODS
Patients with stroke-related trauma were identified among all acute-stroke patients protocoled for intravenous/intraarterial thrombolytic therapy during a two-year period (6/01-5/03). The history and physical examination along with imaging findings and hospital records of these patients were reviewed.


RESULTS
Six patients with stroke-related trauma were identified among 520 protocoled patients. In three, trauma resulted from a fall due to stroke and in three, trauma resulted from a motor vehicle crash due to stroke. Two from the former group sustained fracture (one each wrist and hip) and one from the latter group sustained fracture (sternum) with soft-tissue injury alone in the remaining three. Three of the six stroke-related trauma patients were excluded from consideration of thrombolytic therapy.


CONCLUSIONS
Stroke-related trauma occurred equally from fall and motor vehicle crash in six of 520 patients protocoled for thrombolytic therapy, three with soft-tissue injury alone and three soft-tissue injury and fracture. Three of the six were inappropriately excluded from consideration of thrombolytic therapy.
Finelli
Pasquale F
PF
Department of Neurology, Hartford Hospital, CT 06102-5037, USA. pfinell@harthosp.org
Beland
Dawn
D
D000058:Accidental Falls; D000063:Accidents, Traffic; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications*; D015912:Thrombolytic Therapy; D014947:Wounds and Injuries / Q000188:drug therapy / Q000209:etiology*