Stroke etiologic subtype may influence the rate of hyperdense middle cerebral artery sign disappearance after intravenous thrombolysis

Disappearance of hyperdense middle cerebral artery sign (HMCAS) on non-contrast brain computed tomography (CT) scan is a reliable sign of arterial recanalization after intravenous (IV) thrombolysis for ischemic stroke. We aimed to assess whether stroke etiologic subtype may influence the rate of HMC...

Full description

Saved in:
Bibliographic Details
Published in:Journal of thrombosis and thrombolysis 2017, Vol.43 (1), p.86-90
Main Authors: Forlivesi, Stefano, Bovi, Paolo, Tomelleri, Giampaolo, Micheletti, Nicola, Carletti, Monica, Moretto, Giuseppe, Cappellari, Manuel
Format: Article
Language:English
Subjects:
Administration, Intravenous
Adult
Aged
Cardiology
Female
Fibrinolytic Agents - administration & dosage
Fibrinolytic Agents - therapeutic use
Hematology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Middle Cerebral Artery - pathology
Recovery of Function
Retrospective Studies
Stroke - etiology
Thrombolytic Therapy - methods
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Disappearance of hyperdense middle cerebral artery sign (HMCAS) on non-contrast brain computed tomography (CT) scan is a reliable sign of arterial recanalization after intravenous (IV) thrombolysis for ischemic stroke. We aimed to assess whether stroke etiologic subtype may influence the rate of HMCAS disappearance and the clinical outcome after IV thrombolysis. We conducted a retrospective analysis of data prospectively collected from 1031 consecutive stroke patients treated with IV thrombolysis. Outcome measures were HMCAS disappearance on follow-up CT scan within 22–36 h of IV thrombolysis, neurologic improvement (NIH Stroke Scale [NIHSS] ≤4 points from baseline or NIHSS score of 0) at 7 days, and modified rankin scale (mRS) ≤1 at 3 months. Of 256 patients with HMCAS on admission CT scan, 125 had a cardioembolic stroke, 67 a stroke due to large-artery atherosclerosis (LAA), 58 a stroke of undetermined etiology, and six a stroke secondary to carotid artery dissection. HMCAS disappearance occurred in 145 (56.6 %) patients, neurologic improvement in 122 (55.0 %) patients, and mRS ≤1 in 64 (32.8 %) patients. Compared with cardioembolic stroke patients, patients with stroke due to LAA had lower odds ratios (OR) for HMCAS disappearance (OR 0.29, 95 % CI 0.15–0.58, p 
ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-016-1404-x