Repeat intravenous r-tPA administration four days after initial thrombolytic therapy for recurrent ischemic stroke: A case report and review of literature

Publication date: March 2021Source: Interdisciplinary Neurosurgery, Volume 23Author(s): Aimen Vanood, Sunitha Santhakumar, Ahmad Said
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research

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Abstract Acute ischemic stroke is a neurological emergency with a high likelihood of morbidity, mortality, and long-term disability. Modern stroke care involves multidisciplinary management by neurologists, radiologists, neurosurgeons, and anesthesiologists. Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria. The anesthesia and critical care provider may b...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
AbstractBlood –brain barrier (BBB) dysfunction underlies the pathogenesis of many neurological diseases. Platelet-derived growth factor receptor-alpha (PDGFRα) induces hemorrhagic transformation (HT) downstream of tissue plasminogen activator in thrombolytic therapy of acute stroke. Thus, PDGFs are attractive therapeutic targets for BBB dysfunction. In the present study, we examined the role of PDGF signaling in the process of tissue remodeling after middle cerebral arterial occlusion (MCAO) in mice. Firstly, we found that imatinib increased lesion size after permanent MCAO in wild-type mice. Moreover, i matini...
Source: Angiogenesis - Category: Molecular Biology Source Type: research
Ischemic stroke is the second leading cause of death globally. The narrow time window for administering effective thrombolytic therapy motivates the search for alternative prevention strategies. Microglia and ...
Source: Journal of Neuroinflammation - Category: Neurology Authors: Tags: Research Source Type: research
This study will be a single-blinded, randomized controlled trial with 2 parallel groups. It will be conducted at North China University of science and technology affiliated hospital. Discussion: There is no consistent conclusion about the pathogenesis of wake up stroke. Wake up stroke is more likely to manifest as small vessel disease. The incidence of wake up stroke patients is relatively high, and the effectiveness and safety of intravenous thrombolysis under the guidance of multimode imaging therapy in wake up stroke need to be further explored by prospective, large-scale studies. Trial registration: ClinicalTrial...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
Conclusions: Lower serum magnesium levels in patients with ischemic stroke are associated with an increased risk of HT after intravenous thrombolysis, but perhaps only when serum magnesium is below a certain minimal concentration.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
This study aims to examine clinical risk factors associated with inclusion or exclusion for rtPA in acute ischemic stroke populations with pre-stroke depression in the telestroke versus a non-telestroke setting.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Ischemic strokes can be mild and non-disabling in around two third patients at onset.1 This is one of the major reason for delay in seeking medical attention, non-administration of thrombolytic therapy, incomplete evaluation and non-urgent initiation of secondary preventive strategies. Risk of early recurrence of neurological events is around 12%, with roughly half of them occurring in the first 48  h of onset.2 These strokes are not always associated with excellent outcome with short term disability ranging between 19% and 35% across various studies.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Conclusion: In our cohort, blood ADAMTS13 antigen level before rt-PA therapy could not be used as an independent biomarker in predicting clinical outcomes of AIS patients at 90 days.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSION: The new IHS protocol has led to a marked increase in cases identified, rapid evaluation, and high utilization rate of acute stroke therapies.
Source: Journal of Neuroscience Nursing - Category: Neuroscience Tags: Clinical Nursing Focus Source Type: research
Ischemic stroke is a leading cause of morbidity and mortality. Thrombolytic therapy improves disability and survival rates; however, to be effective, it must be given within 4.5  h of onset. Moreover, thromboly...
Source: BMC Neurology - Category: Neurology Authors: Tags: Research article Source Type: research
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