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Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis

The aim of our study was to compare the rapid neurological improvement after intravenous recombinant tissue-type plasminogen activator (rtPA) in patients with proximal hyperdense middle cerebral artery sign (p-HMCAS) to those without the sign and those with the distal hyperdense middle cerebral arte...

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Detalles Bibliográficos
Autores principales: Li, Qi, Davis, Stephen, Mitchell, Peter, Dowling, Richard, Yan, Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013049/
https://www.ncbi.nlm.nih.gov/pubmed/24804962
http://dx.doi.org/10.1371/journal.pone.0096123
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author Li, Qi
Davis, Stephen
Mitchell, Peter
Dowling, Richard
Yan, Bernard
author_facet Li, Qi
Davis, Stephen
Mitchell, Peter
Dowling, Richard
Yan, Bernard
author_sort Li, Qi
collection PubMed
description The aim of our study was to compare the rapid neurological improvement after intravenous recombinant tissue-type plasminogen activator (rtPA) in patients with proximal hyperdense middle cerebral artery sign (p-HMCAS) to those without the sign and those with the distal hyperdense middle cerebral artery sign (d-HMCAS). Admission and 24 hour non-contrast CT scans of 120 patients with middle cerebral artery (MCA) territory stroke who were treated with intravenous rtPA were assessed for the presence of p-HMCAS and d-HMCAS. The sign was classified according to the site of occlusion. Rapid neurological improvement was defined as ≥50% improvement in the NIHSS score at 24 hours after thrombolysis. Rapid neurological recovery after thrombolysis was assessed and compared between the subgroups. Rapid neurological recovery was less common in the pooled group of patients with either p-HMCAS or d-HMCAS than those without the sign (p<0.01). Patients with p-HMCAS were less likely to have rapid neurological recovery than those with d-HMCAS (p<0.01). However, there was no difference in early neurological recovery between patients with d-HMCAS and those without any hyperdense sign. Our study showed that poor neurological recovery post rtPA was confined to p-HMCAS and not to d-HMCAS, indicating that these signs have quite different prognostic significance.
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spelling pubmed-40130492014-05-09 Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis Li, Qi Davis, Stephen Mitchell, Peter Dowling, Richard Yan, Bernard PLoS One Research Article The aim of our study was to compare the rapid neurological improvement after intravenous recombinant tissue-type plasminogen activator (rtPA) in patients with proximal hyperdense middle cerebral artery sign (p-HMCAS) to those without the sign and those with the distal hyperdense middle cerebral artery sign (d-HMCAS). Admission and 24 hour non-contrast CT scans of 120 patients with middle cerebral artery (MCA) territory stroke who were treated with intravenous rtPA were assessed for the presence of p-HMCAS and d-HMCAS. The sign was classified according to the site of occlusion. Rapid neurological improvement was defined as ≥50% improvement in the NIHSS score at 24 hours after thrombolysis. Rapid neurological recovery after thrombolysis was assessed and compared between the subgroups. Rapid neurological recovery was less common in the pooled group of patients with either p-HMCAS or d-HMCAS than those without the sign (p<0.01). Patients with p-HMCAS were less likely to have rapid neurological recovery than those with d-HMCAS (p<0.01). However, there was no difference in early neurological recovery between patients with d-HMCAS and those without any hyperdense sign. Our study showed that poor neurological recovery post rtPA was confined to p-HMCAS and not to d-HMCAS, indicating that these signs have quite different prognostic significance. Public Library of Science 2014-05-07 /pmc/articles/PMC4013049/ /pubmed/24804962 http://dx.doi.org/10.1371/journal.pone.0096123 Text en © 2014 Li et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Li, Qi
Davis, Stephen
Mitchell, Peter
Dowling, Richard
Yan, Bernard
Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis
title Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis
title_full Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis
title_fullStr Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis
title_full_unstemmed Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis
title_short Proximal Hyperdense Middle Cerebral Artery Sign Predicts Poor Response to Thrombolysis
title_sort proximal hyperdense middle cerebral artery sign predicts poor response to thrombolysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013049/
https://www.ncbi.nlm.nih.gov/pubmed/24804962
http://dx.doi.org/10.1371/journal.pone.0096123
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