Outcomes of patients with large middle cerebral artery infarct treated with and without intravenous thrombolysis

BACKGROUND: Many thrombolytic studies showed that severe stroke was associated with death and having symptomatic intracerebral hemorrhage and inversely related to a favorable outcome. AIMS: The purpose of this study is to compare the outcomes of patients with acute large middle cerebral artery (MCA) infarction with and without intravenous recombinant-tissue-plasminogen activator (rtPA) treatment. METHODS: Patients with acute, large MCA infarction (National Institute of Health Stroke Scale [NIHSS] >15) who were treated during 2011–2014 were studied. The demographic data and the outcomes were compared between patients with and without intravenous rtPA treatment. RESULTS: Two hundred and forty patients were included. Mean NIHSS score was 20. One hundred and twenty patients were treated with intravenous rtPA treatment. The patients with rtPA treatment had higher rates of favorable outcomes (39% vs. 17%, P < 0.001) and lower mortality rate (16% vs. 51%, P < 0.001). There was no significant difference in the occurrence of symptomatic intracerebral hemorrhage (6% vs. 4%, P = 0.715). CONCLUSIONS: The study showed the benefit and safety of intravenous rtPA treatment in patients with acute large MCA infarct.