ASPECTS-DWI, arterial occlusion sites and subtype of acute ischemic stroke have a relation with outcome following intravenous rt-PA therapy

Masaru Idei, Tatsuya Sasaki, Tomoyuki Tanabe, Kenichirou Muraoka, Kinya Terada, Toshinari Meguro, Nobuyuki Hirotsune, Shigeki Nishino

Research output: Contribution to journalArticle

Abstract

Purpose: We evaluated the usefulness of rating diffusion weighted images (DWI) using semiquantitative scores modified from the Alberta Stroke Programme Early CT Score (ASPECTS) to predict deterioration of neurological symptoms in patients with hyperacute ischemic stroke who had undergone thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA). Subjects and methods: We examined 84 patients with acute ischemic stroke treated with intravenous rt-PA. Ischemic changes and vascular lesions were identified using DWI, and magnetic resonance angiography. Early ischemic signs were assessed using ASPECTS-DWI (11 points). Independent outcome was defined by NIHSS at 24 hours after intravenous rt-PA therapy. Results: A total of 58 patients were studied, and NIHSS 27 (46.6%) of them had improved by 4 points in 24 hours. Conclusion: Cases of 0≦AD≦3, cardioembolic type cases with internal carotid artery occlusion in the group of 4≦AD≦7 and branch atheromatous disease in the group of 8≦AD were poor outcome at NIHSS 24 hours after intravenous rt-PA therapy for acute ischemic stroke patients.

Original languageEnglish
Pages (from-to)585-591
Number of pages7
JournalNeurological Surgery
Volume40
Issue number7
Publication statusPublished - Jul 1 2012

Keywords

  • ASPECTS-DWI
  • MRI
  • NIHSS
  • Stroke
  • rt-PA

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Idei, M., Sasaki, T., Tanabe, T., Muraoka, K., Terada, K., Meguro, T., Hirotsune, N., & Nishino, S. (2012). ASPECTS-DWI, arterial occlusion sites and subtype of acute ischemic stroke have a relation with outcome following intravenous rt-PA therapy. Neurological Surgery, 40(7), 585-591.