title: Treatment outcomes of tissue plasminogen activator infusion for branch atheromatous disease.
abstract: BACKGROUND
  The objective of this study was to evaluate treatment outcomes of tissue plasminogen activator (t-PA) infusion for hyperacute branch atheromatous disease (BAD) within 3 hours after onset.
  
  
  METHODS
  A total of 152 BAD patients with lenticulostriate artery (LSA) or paramedian pontine artery (PPA) territory infarcts (LSA 114; PPA 38) were hospitalized between April 2007 and June 2012. Of these, 21 BAD patients (LSA 19; PPA 2) arrived at the hospital within 3 hours after onset, and, among these, 8 patients who received t-PA infusion (.6 mg/kg) were included in this study. All BAD patients who received t-PA infusion had LSA territory infarcts.
  
  
  RESULTS
  Six of 8 patients (75%) had improvement of neurologic findings within 60 minutes after t-PA infusion, but neurologic findings deteriorated within 24 hours in 4 of these patients (67%). In all patients with deterioration, diffusion-weighted imaging after 24 hours revealed infarct expansion. One patient (13%) had symptomatic intracranial hemorrhage. After 3 months, the modified Rankin Scale (mRS) score was 0 to 2 in 6 patients (75%) and 3 to 6 in 2 patients (25%).
  
  
  CONCLUSIONS
  With t-PA infusion for BAD, symptoms transiently improved, but the rate of symptom deterioration was high. The outcome after 3 months was relatively good.
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Saitama, Japan. Electronic address: ideguchi@saitama-med.ac.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Deguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kato
authors.forename: Harumitsu
authors.initials: H
authors.lastname: Nagoya
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Ohe
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukuoka
authors.forename: Hajime
authors.initials: H
authors.lastname: Maruyama
authors.forename: Yohsuke
authors.initials: Y
authors.lastname: Horiuchi
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000503:physiopathology; D020521:Stroke / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator