- AutorIn
- Volker Pütz
- Imanuel Dzialowski
- Michael D. Hill
- Nikolai Steffenhagen
- Shelagh B. Coutts
- Christine O’Reilly
- Andrew M. Demchuk
- Titel
- Malignant Profile Detected by CT Angiographic Information Predicts Poor Prognosis despite Thrombolysis within Three Hours from Symptom Onset
- Zitierfähige Url:
- https://nbn-resolving.org/urn:nbn:de:bsz:14-qucosa-135274
- Quellenangabe
- Cerebrovasc Dis 2010;29:584–591, ISSN: 1015-9770
- Erstveröffentlichung
- 2010
- Abstract (DE)
- Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
- Abstract (EN)
- Objective: A malignant profile of early brain ischemia has been demonstrated in the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution (DEFUSE) trial. Patients with a malignant profile had a low chance for an independent functional outcome despite thrombolysis within 3–6 h. We sought to determine whether CT angiography (CTA) could identify a malignant imaging profile within 3 h from symptom onset. Methods: We studied consecutive patients (04/02–09/07) with anterior circulation stroke who received CTA before intravenous thrombolysis within 3 h. We assessed the Alberta Stroke Program Early CT Score (ASPECTS) on CTA source images (CTASI). Intracranial thrombus burden on CTA was assessed with a novel 10-point clot burden score (CBS). We analyzed percentages independent (modified Rankin Scale score ≤2) and fatal outcome at 3 months and parenchymal hematoma rates across categorized combined CTASI-ASPECTS + CBS score groups where 20 is best and 0 is worst. Results: We identified 114 patients (median age 73 years [interquartile range 61–80], onset-to-tPA time 129 min [95–152]). Among 24 patients (21%) with extensive hypoattenuation on CTASI and extensive thrombus burden (combined score ≤10), only 4% (1/24) were functionally independent whereas mortality was 50% (12/24). In contrast, 57% (51/90) of patients with less affected scores (combined score 11–20) were functionally independent and mortality was 10% (9/90; p < 0.001). Parenchymal hematoma rates were 30% (7/23) vs. 8% (7/88), respectively (p = 0.008). Conclusion: CTA identifies a large hyperacute stroke population with high mortality and low likelihood for independent functional outcome despite early thrombolysis.
- Andere Ausgabe
- DOI: 10.1159/000311079
- Volltext des Artikels, der zuerst in der Zeitschrift "Cerebrovascular Diseases" des Karger-Verlages erschienen ist.
Link: http://dx.doi.org/10.1159/000311079 - Freie Schlagwörter (DE)
- akuter Schlaganfall, Schlaganfall, CT-Angiografie, Thrombolyse
- Freie Schlagwörter (EN)
- Acute stroke, CT angiography, Stroke, functional outcome, Thrombolysis
- Klassifikation (DDC)
- 610
- Klassifikation (RVK)
- XA 10000
- Verlag
- Karger, Basel
- URN Qucosa
- urn:nbn:de:bsz:14-qucosa-135274
- Veröffentlichungsdatum Qucosa
- 26.02.2014
- Dokumenttyp
- Artikel
- Sprache des Dokumentes
- Englisch
- Lizenz / Rechtehinweis