Titre
Intravenous thrombolysis in stroke attributable to cervical artery dissection.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Engelter, S.T.
Auteure/Auteur
Rutgers, M.P.
Auteure/Auteur
Hatz, F.
Auteure/Auteur
Georgiadis, D.
Auteure/Auteur
Fluri, F.
Auteure/Auteur
Sekoranja, L.
Auteure/Auteur
Schwegler, G.
Auteure/Auteur
Müller, F.
Auteure/Auteur
Weder, B.
Auteure/Auteur
Sarikaya, H.
Auteure/Auteur
Lüthy, R.
Auteure/Auteur
Arnold, M.
Auteure/Auteur
Nedeltchev, K.
Auteure/Auteur
Reichhart, M.
Auteure/Auteur
Mattle, H.P.
Auteure/Auteur
Tettenborn, B.
Auteure/Auteur
Hungerbühler, H.J.
Auteure/Auteur
Sztajzel, R.
Auteure/Auteur
Baumgartner, R.W.
Auteure/Auteur
Michel, P.
Auteure/Auteur
Lyrer, P.A.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1524-4628
Statut éditorial
Publié
Date de publication
2009
Volume
40
Numéro
12
Première page
3772
Dernière page/numéro d’article
3776
Peer-reviewed
Oui
Langue
anglais
Résumé
BACKGROUND AND PURPOSE: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Whether this is also true for cervical artery dissection (CAD) is addressed in this study.METHODS: We used the Swiss IVT databank to compare outcome and complications of IVT-treated patients with CAD with IVT-treated patients with other etiologies (non-CAD patients). Main outcome and complication measures were favorable 3-month outcome, intracranial cerebral hemorrhage, and recurrent ischemic stroke. Modified Rankin Scale score <or=1 at 3 months was considered favorable.RESULTS: Fifty-five (5.2%) of 1062 IVT-treated patients had CAD. Patients with CAD were younger (median age 50 versus 70 years) but had similar median National Institutes of Health Stroke Scale scores (14 versus 13) and time to treatment (152.5 versus 156 minutes) as non-CAD patients. In the CAD group, 36% (20 of 55) had a favorable 3-month outcome compared with 44% (447 of 1007) non-CAD patients (OR, 0.72; 95% CI, 0.41 to 1.26), which was less favorable after adjustment for age, gender, and National Institutes of Health Stroke Scale score (OR, 0.50; 95% CI, 0.27 to 0.95; P=0.03). Intracranial cerebral hemorrhages (asymptomatic, symptomatic, fatal) were equally frequent in CAD (14% [7%, 7%, 2%]) and non-CAD patients (14% [9%, 5%, 2%]; P=0.99). Recurrent ischemic stroke occurred in 1.8% of patients with CAD and in 3.7% of non-CAD-patients (P=0.71).CONCLUSIONS: IVT-treated patients with CAD do not recover as well as IVT-treated non-CAD patients. However, intracranial bleedings and recurrent ischemic strokes were equally frequent in both groups. They do not account for different outcomes and indicate that IVT should not be excluded in patients who may have CAD. Hemodynamic compromise or frequent tandem occlusions might explain the less favorable outcome of patients with CAD.
PID Serval
serval:BIB_F1AEBEBF36B5
PMID
Open Access
Oui
Date de création
2011-10-27T07:59:24.761Z
Date de création dans IRIS
2025-05-21T05:42:04Z