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Cerebral angiography and intraarterial thrombolysis with streptokinase in acute ischemic stroke
ORAL SESSION
882
O1-1-8 Cerebral angiography and intraarterial thrombolysis with streptokinase in acute ischemic stroke Shukhrat Mubarakov
Department of Neurology, Republic
Research Center of Emergency Medicine, Uzbekistan.
Farrukh Djalalov, and Amet Seydaliev Department of Neurology, Republic Research Center of Emergency Medicine, Uzbekistan
【Background and Purpose】The purpose of this study was to evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) using Streptokinase under cerebral angiography control (CAC) in patients with acute ischemic stroke due to middle cerebral artery (MCA) occlusion. 【Methods】After angiographic detection of artery occlusion IAT with Streptokinase in dose 100,000 units under CAC was applied. 32 patients (20 male, 12 female, aged 22-85 years, average age 57,8 ± 13,3) were investigated. All patients were selected by National Institute of Neurological Disorders and Stroke (NINDS) recommendations. To measure outcome National Institutes of Health Stroke Scale (NIHSS), the modified Rankin scale (mRs) were used. 【Results】MCA occlusion was detected by CA in all patients. NIHSS average score at admission was 14,3 ± 3,7, 272 ± 36.5 minutes elapsed from symptom onset. 16 patients (50%) had excellent outcome (mRs score 0 to 1), 10 patients (30%) a good outcome (mRs score 2), 6 patients (20%) had no changes (mRs score 3 to 4). In these 6 patients brain ischemic zone was detected on control CT. In group with excellent and good outcomes 3 patients had asymptomatic hemorrhagic transformation (AHT) with small petechiae along the margins of infarct zone. Vessel recanalization was 80%. Average NIHSS score improved from 14,3 ± 3,7 to 7,9 ± 5,8. Average Rankin score improved from 4,5 ± 0,6 to 2,6 ± 1,5 No patients died. 【Conclusions】IAT with streptokinase under CAC administered in closely selected patients can be considered as effective method in patients with acute ischemic stroke. Thrombolysis-related AHT is a marker of successful recanalization.
O1-1-9 Spinal cord injury misdiagnosed as cerebral infarction and given thrombolytic therapy: A case report Jie Yang
of neurological deficits, which can be confused with cerebral infarction when patients present with hemiparesis and a history of minor injury. 【Methods】A 56-year-old man presented with weakness of the left limbs along with shoulder and back pain of three and half hours duration with normal findings on brain computed tomography and thoracic and abdominal computed tomography angiography. He was diagnosed as cerebral infarction and given intravenous thrombolytic treatment. On retaking his history, it was found that he had suffered a traumatic injury 2 days ago without headache and back pain. Additionally, sensory disturbance presenting as hypoalgesia was detected below the right C-4 dermatome level. Hence, the patient underwent cerebral and cervical magnetic resonance imaging after administration of strong analgesia. T2-weighted imaging revealed focal hyperintensity of the spinal cord at levels C6/7 on the left. Following this, the diagnosis was corrected as spinal cord injury and he underwent successful surgical management. The patient made a full recovery by 12 days post-admission. 【Results】Potential reasons for misdiagnosis were as follows:- Firstly, not only did the clinician omit some important medical history, but he also neglected performing a systematic neurological examination. Secondly, essential imaging was delayed in part due to the incorrect initial diagnosis. 【Conclusion】Although hemiparesis due to spinal cord injury is not common, when patients with hemiparesis present with back pain and minor injury history, spinal cord injury should still be considered as an important differential diagnosis.
O1-2-1 Assessment of DWI profile in acute ischemic stroke Manabu Inoue
Department of Cerebrovascular Medicine,
National Cerebral and Cardiovascular Center, Japan.
Kazutaka Sonoda,1 Shinichi Wada,1 Sohei Yoshimura,1 Shoichiro Sato,1 Mikito Hayakawa,1 Hiroshi Yamagami,2 Kazuyuki Nagatsuka,2 and Kazunori Toyoda1 1
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Japan 2 Department of Neurology, National Cerebral and Cardiovascular Center, Japan
Department of Neurology, Nanjing First Hospital, Nanjing
Medical University, China.
Jing Hang, Junshan Zhou, and Yingdong Zhang Department of Neurology, Nanjing First Hospital, Nanjing Medical University, China
【Background】Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) covers a broad spectrum
【Background】The efficacy of endovascular therapy (EVT) in acute stroke has been established but the imaging criteria have not yet been assessed. “Malignant profile” is a magnetic resonance imaging (MRI) pattern that is associated with poor outcomes. We estimated this profile by diffusion weighted image (DWI) in patients treated with EVT.
882
O1-1-8 Cerebral angiography and intraarterial thrombolysis with streptokinase in acute ischemic stroke Shukhrat Mubarakov
Department of Neurology, Republic
Research Center of Emergency Medicine, Uzbekistan.
Farrukh Djalalov, and Amet Seydaliev Department of Neurology, Republic Research Center of Emergency Medicine, Uzbekistan
【Background and Purpose】The purpose of this study was to evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) using Streptokinase under cerebral angiography control (CAC) in patients with acute ischemic stroke due to middle cerebral artery (MCA) occlusion. 【Methods】After angiographic detection of artery occlusion IAT with Streptokinase in dose 100,000 units under CAC was applied. 32 patients (20 male, 12 female, aged 22-85 years, average age 57,8 ± 13,3) were investigated. All patients were selected by National Institute of Neurological Disorders and Stroke (NINDS) recommendations. To measure outcome National Institutes of Health Stroke Scale (NIHSS), the modified Rankin scale (mRs) were used. 【Results】MCA occlusion was detected by CA in all patients. NIHSS average score at admission was 14,3 ± 3,7, 272 ± 36.5 minutes elapsed from symptom onset. 16 patients (50%) had excellent outcome (mRs score 0 to 1), 10 patients (30%) a good outcome (mRs score 2), 6 patients (20%) had no changes (mRs score 3 to 4). In these 6 patients brain ischemic zone was detected on control CT. In group with excellent and good outcomes 3 patients had asymptomatic hemorrhagic transformation (AHT) with small petechiae along the margins of infarct zone. Vessel recanalization was 80%. Average NIHSS score improved from 14,3 ± 3,7 to 7,9 ± 5,8. Average Rankin score improved from 4,5 ± 0,6 to 2,6 ± 1,5 No patients died. 【Conclusions】IAT with streptokinase under CAC administered in closely selected patients can be considered as effective method in patients with acute ischemic stroke. Thrombolysis-related AHT is a marker of successful recanalization.
O1-1-9 Spinal cord injury misdiagnosed as cerebral infarction and given thrombolytic therapy: A case report Jie Yang
of neurological deficits, which can be confused with cerebral infarction when patients present with hemiparesis and a history of minor injury. 【Methods】A 56-year-old man presented with weakness of the left limbs along with shoulder and back pain of three and half hours duration with normal findings on brain computed tomography and thoracic and abdominal computed tomography angiography. He was diagnosed as cerebral infarction and given intravenous thrombolytic treatment. On retaking his history, it was found that he had suffered a traumatic injury 2 days ago without headache and back pain. Additionally, sensory disturbance presenting as hypoalgesia was detected below the right C-4 dermatome level. Hence, the patient underwent cerebral and cervical magnetic resonance imaging after administration of strong analgesia. T2-weighted imaging revealed focal hyperintensity of the spinal cord at levels C6/7 on the left. Following this, the diagnosis was corrected as spinal cord injury and he underwent successful surgical management. The patient made a full recovery by 12 days post-admission. 【Results】Potential reasons for misdiagnosis were as follows:- Firstly, not only did the clinician omit some important medical history, but he also neglected performing a systematic neurological examination. Secondly, essential imaging was delayed in part due to the incorrect initial diagnosis. 【Conclusion】Although hemiparesis due to spinal cord injury is not common, when patients with hemiparesis present with back pain and minor injury history, spinal cord injury should still be considered as an important differential diagnosis.
O1-2-1 Assessment of DWI profile in acute ischemic stroke Manabu Inoue
Department of Cerebrovascular Medicine,
National Cerebral and Cardiovascular Center, Japan.
Kazutaka Sonoda,1 Shinichi Wada,1 Sohei Yoshimura,1 Shoichiro Sato,1 Mikito Hayakawa,1 Hiroshi Yamagami,2 Kazuyuki Nagatsuka,2 and Kazunori Toyoda1 1
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Japan 2 Department of Neurology, National Cerebral and Cardiovascular Center, Japan
Department of Neurology, Nanjing First Hospital, Nanjing
Medical University, China.
Jing Hang, Junshan Zhou, and Yingdong Zhang Department of Neurology, Nanjing First Hospital, Nanjing Medical University, China
【Background】Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) covers a broad spectrum
【Background】The efficacy of endovascular therapy (EVT) in acute stroke has been established but the imaging criteria have not yet been assessed. “Malignant profile” is a magnetic resonance imaging (MRI) pattern that is associated with poor outcomes. We estimated this profile by diffusion weighted image (DWI) in patients treated with EVT.