title: Characteristics and outcome of patients with early complete neurological recovery after thrombolysis for acute ischemic stroke.
abstract: BACKGROUND
  Recombinant tissue plasminogen activator (rt-PA) is the only approved specific therapy for acute ischemic stroke. This study analyzes demographic and clinical characteristics of patients with early complete neurological recovery after thrombolysis.
  
  
  METHODS
  Data of 320 consecutive patients treated with rt-PA within 3 h of stroke onset at our facility between April 2006 and March 2009 were extracted from our prospective institutional stroke and thrombolysis database. Baseline demographic parameters, risk factors, clinical characteristics as well as neuroradiologic findings of patients with complete recovery 24 h after treatment and at hospital discharge were analyzed. Outcome was evaluated using the modified Rankin Scale at 90 days.
  
  
  RESULTS
  Thirty patients (9.4%) were asymptomatic 24 h after thrombolysis and 70 (22%) at hospital discharge. Patients with complete recovery were younger, more often male, had milder stroke symptoms, less often cardioembolic strokes, fewer bleeding complications and more often normal follow-up imaging. In addition, in-hospital time was shorter and these patients retained a better functional outcome at 90 days. Only 1 patient who had completely recovered at hospital discharge died during the follow-up time. In multivariate regression analysis, only the National Institute of Health Stroke Score (NIHSS) on admission was predictive for complete recovery at both examined time points.
  
  
  CONCLUSIONS
  Rapid complete recovery can be achieved in up to a fifth of acute stroke patients treated with thrombolysis. These patients are younger and have milder strokes, less often with cardioembolic origin. Better outcome and lower mortality are sustained at 3 months.
authors.affiliation: Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany. christian.blinzler@uk-erlangen.de
authors.forename: C
authors.initials: C
authors.lastname: Blinzler
authors.forename: L
authors.initials: L
authors.lastname: Breuer
authors.forename: H B
authors.initials: HB
authors.lastname: Huttner
authors.forename: P D
authors.initials: PD
authors.lastname: Schellinger
authors.forename: S
authors.initials: S
authors.lastname: Schwab
authors.forename: M
authors.initials: M
authors.lastname: Köhrmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D016009:Chi-Square Distribution; D019992:Databases as Topic; D004185:Disability Evaluation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D016017:Odds Ratio; D010351:Patient Discharge; D011994:Recombinant Proteins / Q000008:administration & dosage; D020127:Recovery of Function; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator