Lesion patterns in successful and failed thrombolysis in middle cerebral artery stroke View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-07-25

AUTHORS

Rüdiger J. Seitz, Verena Sondermann, Hans-Jörg Wittsack, Mario Siebler

ABSTRACT

IntroductionThrombolysis has been shown to improve neurological recovery in acute stroke. But the response to thrombolysis is variable across patients. We sought to investigate this variability by analyzing the lesion patterns following systemic thrombolysis with recombinant tissue plasminogen activator (rtPA) and tirofiban in middle cerebral artery (MCA) stroke.MethodsOne hundred three consecutive stroke patients (67 ± 14 years) were grouped according to the site of MCA occlusion and successful or failed recanalization as assessed with magnetic resonance angiography. Infarct lesions were analyzed in T2-weighted magnetic resonance images after 10 days.ResultsPatients recovered markedly upon successful recanalization following thrombolysis (p < 0.05) but remained severely impaired when there was no recanalization within 24 h. Infarct lesions were smaller after successful than after failed recanalization (p < 0.005). They occurred throughout the cerebral cortex on the cerebral convexity in distal MCA occlusions with large individual heterogeneity. In contrast, there was a large lesion overlap in insular cortex, basal ganglia, internal capsule, and paraventricular white matter in proximal MCA occlusions.ConclusionSystemic thrombolysis with rtPA and tirofiban of MCA occlusions resulted in early neurological recovery and preferentially peri-insular infarcts. In failed recanalization of the MCA stem there was a large lesion overlap in the hemispheric white matter and a lack of recovery. More... »

PAGES

865-871

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00234-009-0576-x

DOI

http://dx.doi.org/10.1007/s00234-009-0576-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1015662889

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19633834


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204 Department of Neurology, Mediclin Fachklinik Rhein Ruhr, Essen, Germany
205 schema:name Biomedical Research Centre, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
206 Brain Imaging Centre West, Jülich, Germany
207 Department of Neurology, Mediclin Fachklinik Rhein Ruhr, Essen, Germany
208 Department of Neurology, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
209 rdf:type schema:Organization
210 grid-institutes:grid.14778.3d schema:alternateName Department of Neurology, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
211 Institute of Diagnostic Radiology, University Hospital Düsseldorf, Düsseldorf, Germany
212 schema:name Department of Neurology, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
213 Institute of Diagnostic Radiology, University Hospital Düsseldorf, Düsseldorf, Germany
214 rdf:type schema:Organization
 




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