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von Kummer, R.* ; Allen, K.L.* ; Holle, R. ; Bozzao, L.* ; Bastianello, S.* ; Manelfe, C.* ; Bluhmki, E.* ; Ringleb, P.* ; Meier, D.H.* ; Hacke, W.*

Acute stroke: Usefulness of early CT findings before thrombolytic therapy.

Radiology 205, 327-333 (1997)
PMC
Open Access Green as soon as Postprint is submitted to ZB.
PURPOSE: To determine whether the extent of subtle parenchymal hypoattenuation detected on computed tomographic (CT) scans obtained within 6 hours of ischemic stroke is a factor in predicting patients' response to thrombolytic treatment. MATERIALS AND METHODS: The baseline CT scans of 620 patients, who received either recombinant tissue plasminogen activator (rt-PA) or a placebo, in a double-blind, randomized multicenter trial were prospectively evaluated and assigned to one of three categories according to the extent of parenchymal hypoattenuation: none, 33% or less (small), or more than 33% (large) of the middle cerebral artery territory. The association between the extent of hypoattenuation on the baseline CT scans and the clinical outcome in the placebo-treated and the rt-PA-treated groups after 3 months was analyzed. RESULTS: In 215 patients with a small hypoattenuating area, treatment increased the chance of good outcome. In 336 patients with a normal CT scan and in 52 patients with a large hypoattenuating area, rt-PA had no beneficial effect but increased the risk for fatal brain hemorrhage. CONCLUSION: The response to rt-PA in patients with ischemic stroke can be predicted on the basis of initial CT findings of the extent of parenchymal hypoattenuation in the territory of the middle cerebral artery.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords brain; brain, edema; brain, infarction; brain, ischemia; cerebral blood vessels, thrombosis; thrombolysis; EXPERIMENTAL BRAIN INFARCTS; CEREBRAL INFARCTION; AGREEMENT; EDEMA; CATS
ISSN (print) / ISBN 0033-8419
e-ISSN 1527-1315
Journal Radiology
Quellenangaben Volume: 205, Issue: 2, Pages: 327-333 Article Number: , Supplement: ,
Publisher Radiological Society of North America
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Health Economics and Health Care Management (IGM)