Stroke quiz

A high NIHSS score (indicative of a severe stroke) is an independent risk factor for intracerebral haemorrhage after treatment with tissue plasminogen activator. 9 10 The National Institute of Neurological Disorders and Stroke study found that an NIHSS score greater than 20 was associated with an 11...

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Bibliographic Details
Published in:BMJ 2009, Vol.339 (sep02 2), p.b3343-b3343
Main Authors: Mazumder, Asif Atik, Pope, George Anthony
Format: Article
Language:English
Subjects:
Aphasia
Heart attacks
Signs
Stroke
Tomography
Veins & arteries
Online Access:Get full text
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Summary:A high NIHSS score (indicative of a severe stroke) is an independent risk factor for intracerebral haemorrhage after treatment with tissue plasminogen activator. 9 10 The National Institute of Neurological Disorders and Stroke study found that an NIHSS score greater than 20 was associated with an 11-fold increased risk of symptomatic intracerebral haemorrhage compared with a score of 5 or less after thrombolytic treatment. 6 However, the NIHSS score should be considered in combination with other factors that influence the risk to benefit ratio of thrombolytic treatment after stroke, including brain oedema and mass effect. 6 Strict management of blood pressure to a therapeutic protocol is also suggested, as well as careful attention to pretherapeutic glycaemic values. 11 4 ECASS category The grading system pioneered by the European Cooperative Acute Stroke study categorises haemorrhagic transformation of strokes after thrombolysis into the following groups 12 13 :
ISSN:0959-8138
1468-5833
1756-1833
DOI:10.1136/bmj.b3343