title: Thrombolysis in dementia patients with acute stroke: is it justified?
abstract: The administration of thrombolytic therapy in elderly patients with dementia and acute ischemic stroke may be controversial, because the reported risk of rt-PA associated intracerebral hemorrhage in these patients is higher compared with that of patients without dementia and because these patients are already disabled. Moreover, there are known risk factors for hemorrhagic transformation in patients with dementia: amyloid angiopathy, leukoaraiosis and the presence of microbleeds. In this review, we describe the impact of dementia on functional outcome following thrombolytic therapy for acute ischemic stroke and discuss some of the issues related to the use of this therapy in this specific patient's population.
authors.affiliation: Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Santa Maria della Misericordia Hospital, 06126, Perugia, Italy. maurizio.paciaroni@unipg.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Paciaroni
authors.affiliation: NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy. leonardo.pantoni@unifi.it.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D003704:Dementia / Q000150:complications*; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Amyloid angiopathy; Cerebral hemorrhage; Dementia; Outcome; Small vessel disease; rt-PA