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Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse?

Management of stroke with minor symptoms may represent a therapeutical dilemma as the hemorrhage risk of acute thrombolytic therapy may eventually outweigh the stroke severity. However, around 30% of patients presenting with minor stroke symptoms are ultimately left with disability. The objective of...

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Detalles Bibliográficos
Autores principales: Ferrari, Julia, Reynolds, Audrey, Knoflach, Michael, Sykora, Marek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637329/
https://www.ncbi.nlm.nih.gov/pubmed/34867745
http://dx.doi.org/10.3389/fneur.2021.760813
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author Ferrari, Julia
Reynolds, Audrey
Knoflach, Michael
Sykora, Marek
author_facet Ferrari, Julia
Reynolds, Audrey
Knoflach, Michael
Sykora, Marek
author_sort Ferrari, Julia
collection PubMed
description Management of stroke with minor symptoms may represent a therapeutical dilemma as the hemorrhage risk of acute thrombolytic therapy may eventually outweigh the stroke severity. However, around 30% of patients presenting with minor stroke symptoms are ultimately left with disability. The objective of this review is to evaluate the current literature and evidence regarding the management of minor stroke, with a particular emphasis on the role of IV thrombolysis. Definition of minor stroke, pre-hospital recognition of minor stroke and stroke of unknown onset are discussed together with neuroimaging aspects and existing evidence for IV thrombolysis in minor strokes. Though current guidelines advise against the use of thrombolysis in those without clearly disabling symptoms due to a paucity of evidence, advanced imaging techniques may be able to identify those likely to benefit. Further research on this topic is ongoing.
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spelling pubmed-86373292021-12-03 Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse? Ferrari, Julia Reynolds, Audrey Knoflach, Michael Sykora, Marek Front Neurol Neurology Management of stroke with minor symptoms may represent a therapeutical dilemma as the hemorrhage risk of acute thrombolytic therapy may eventually outweigh the stroke severity. However, around 30% of patients presenting with minor stroke symptoms are ultimately left with disability. The objective of this review is to evaluate the current literature and evidence regarding the management of minor stroke, with a particular emphasis on the role of IV thrombolysis. Definition of minor stroke, pre-hospital recognition of minor stroke and stroke of unknown onset are discussed together with neuroimaging aspects and existing evidence for IV thrombolysis in minor strokes. Though current guidelines advise against the use of thrombolysis in those without clearly disabling symptoms due to a paucity of evidence, advanced imaging techniques may be able to identify those likely to benefit. Further research on this topic is ongoing. Frontiers Media S.A. 2021-11-18 /pmc/articles/PMC8637329/ /pubmed/34867745 http://dx.doi.org/10.3389/fneur.2021.760813 Text en Copyright © 2021 Ferrari, Reynolds, Knoflach and Sykora. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Ferrari, Julia
Reynolds, Audrey
Knoflach, Michael
Sykora, Marek
Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse?
title Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse?
title_full Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse?
title_fullStr Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse?
title_full_unstemmed Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse?
title_short Acute Ischemic Stroke With Mild Symptoms–To Thrombolyse or Not to Thrombolyse?
title_sort acute ischemic stroke with mild symptoms–to thrombolyse or not to thrombolyse?
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637329/
https://www.ncbi.nlm.nih.gov/pubmed/34867745
http://dx.doi.org/10.3389/fneur.2021.760813
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