title: Doppler ultrasound and clinical findings in patients with acute ischemic stroke treated with intravenous thrombolysis.
abstract: The aim of this study was to assess cerebral hemodynamics in patients with acute ischemic stroke undergoing thrombolytic therapy and to assess the relationship between cerebral hemodynamics and outcome. Forty-one unselected patients admitted to hospital within 3 h received intravenous thrombolytic therapy and were examined by extracranial and transcranial Doppler ultrasound examinations. Their strokes were clinically graded with the National Institute of Health Stroke Scale. Outcome after 3 months was graded with the modified Rankin Scale. Amongst the 27 patients who had an additional ultrasound examination 24 h after treatment, favorable outcome was significantly more common amongst patients with recanalization than amongst those without (P < 0.004). Thirteen patients with middle cerebral artery occlusions were continuously monitored during thrombolysis and frequently up to 5 h after start of thrombolysis. Early recanalization occurred in nine (69%), at a median delay of 178 min (range 140-287) after stroke onset. All of these nine patients had a favorable outcome. Recanalization within 24 h was associated with favorable outcome. Subgroup analysis suggests that this effect is mostly related to early recanalization within the first 5 h after stroke. Transcranial Doppler may therefore help to identify those patients most probably to benefit from thrombolysis, especially in those patients with a higher potential risk of complications.
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway. lars.thomassen@haukeland.no
authors.forename: L
authors.initials: L
authors.lastname: Thomassen
authors.forename: U
authors.initials: U
authors.lastname: Waje-Andreassen
authors.forename: H
authors.initials: H
authors.lastname: Naess
authors.forename: J
authors.initials: J
authors.lastname: Aarseth
authors.forename: D
authors.initials: D
authors.lastname: Russell
mesh_terms: D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
chemical_list: D010959:Tissue Plasminogen Activator