Stroke Mimics and Acute Stroke Evaluation: Clinical Differentiation and Complications after Intravenous Tissue Plasminogen Activator

2015 ◽  
Vol 49 (2) ◽  
pp. 244-252 ◽  
Author(s):  
Peggy L. Nguyen ◽  
Jason J. Chang
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Stroke Mimics ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Abstract WP72: Early Experience on Intravenous Tissue Plasminogen Activator Delivery in Mobile Stroke Unit Patients with Stroke Mimics

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lila E Sheikhi ◽  
Stacey Winners ◽  
Pravin George ◽  
Andrew Russman ◽  
Zeshaun Khawaja ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Stroke Unit ◽  
Early Experience ◽  
Final Diagnosis ◽  
Stroke Mimics ◽  
Intravenous Tissue Plasminogen Activator ◽  
Mobile Stroke Unit ◽  
Tissue Plasminogen ◽  
Iv Tpa

Background: A mobile stroke unit (MSU) allows for early delivery for intravenous tissue plasminogen activator (IV-tPA). A proportion of IV-tPA treated patients may turn out to be stroke mimics. We evaluated the rate and complications seen in stroke mimics treated with tPA from our early experience on MSU. Methods: Retrospective review of patients treated with IV-tPA on the MSU from 2014 to 2016. Charts were reviewed for confirmed strokes by imaging (MRI or CT) and hemorrhagic transformation. Stroke mimics were defined as those without imaging evidence of infarction and a final diagnosis which was not suspected to be stroke. Results: Among 62 patients treated with IV-tPA, 14 (28.6%) had a final diagnosis consistent with a stroke mimics. The majority of these occurred in the first year of the MSU program. Most common mimics included conversion disorder (n=5) and seizures (n=5). While the last known well to IV-tPA times were similar, the MSU door-to-needle time was significantly longer in stroke mimics (38 vs 31 minutes, p = 0.03). No intracerebral hemorrhages or other IV-tPA related complications were identified in the stroke mimics group. Conclusions: In our early experience with MSU, treatment of stroke mimics occurred without IV-tPA related complications. This does not appear to be due to rushed decision making.

Acute stroke thrombolysis with intravenous tissue plasminogen activator in an Australian tertiary hospital

2003 ◽  
Vol 178 (7) ◽  
pp. 324-328 ◽  
Author(s):  
Cassandra E I Szoeke ◽  
Mark W Parsons ◽  
Kenneth S Butcher ◽  
Tracey A Baird ◽  
Peter J Mitchell ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Tertiary Hospital ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Stroke Thrombolysis

scholarly journals Intravenous Thrombolysis for a Stroke Mimic Patient

2021 ◽  
pp. 704-709
Author(s):  
Lilly Nguyen ◽  
Joyce Hoonsuh Lee ◽  
Latha Ganti ◽  
Mark Rivera-Morales ◽  
Larissa Dub
Keyword(s):  
Cerebrovascular Disease ◽  
Acute Stroke ◽  
Plasminogen Activator ◽  
Young Woman ◽  
Intravenous Thrombolysis ◽  
Herbal Supplements ◽  
Stroke Mimics ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Stroke Mimic

The authors present the case of a young woman on phentermine and herbal supplements who presented as an acute stroke alert with right-sided facial droop and numbness. She was treated acutely with intravenous tissue plasminogen activator (tPA). However, the workup did not reveal any evidence of cerebrovascular disease or cerebral infarct. The authors discuss plausible stroke mimics and the safety of administering tPA to such patients.

scholarly journals Endovascular therapy for acute stroke: Quo vadis?

2013 ◽  
Vol 02 (02) ◽  
pp. 119-123
Author(s):  
Venkatesh Madhugiri ◽  
Paritosh Pandey
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Endovascular Therapy ◽  
Stent Retriever ◽  
Current Status ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Quo Vadis ◽  
Iv Tpa

Abstract Endovascular therapy (EVT) has gained vogue in the management of patients with acute stroke. Newer stent-retriever devices have led to better recanalization rates. In many centers, EVT is slowly being used as an add on to or in some instances, even as an alternative to intravenous tissue plasminogen activator (IV tPA). The publication of the results of the SYNTHESIS expansion, Interventional Management of Stroke III and Mechanical Retrieval Recanalization of Stroke Clots Using Embolectomy trials in 2013 has questioned the enthusiastic use of EVT in acute stroke. They demonstrate that EVT (using a variety of devices) is no superior to IV tPA in the management of acute stroke. In the light of these controversial findings, we review the current status of EVT in the management of acute stroke.

The randomized study of endovascular therapy with versus without intravenous tissue plasminogen activator in acute stroke with ICA and M1 occlusion (SKIP study)

2019 ◽  
Vol 14 (7) ◽  
pp. 752-755 ◽  
Author(s):  
Kentaro Suzuki ◽  
Kazumi Kimura ◽  
Masataka Takeuchi ◽  
Masafumi Morimoto ◽  
Ryuzaburo Kanazawa ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Endovascular Therapy ◽  
Randomized Study ◽  
Intravenous Thrombolysis ◽  
Stroke Patients ◽  
Bridging Therapy ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Rationale Bridging therapy with endovascular therapy (EVT) and intravenous thrombolysis (IVT) has been reported to improve outcomes for acute stroke patients with large-vessel occlusion in the anterior circulation. While the IVT may increase the reperfusion rate, the risk of hemorrhagic complications increases. Whether EVT without IVT (direct EVT) is equally effective as bridging therapy in acute stroke remains unclear. Aim This randomized study of endovascular therapy with versus without intravenous tissue plasminogen activator for acute stroke with ICA and M1 occlusion aims to clarify the efficacy and safety of direct EVT compared with bridging therapy. Methods and design This is an investigator-initiated, multicenter, prospective, randomized, open-treatment, blinded-endpoint clinical trial. The target patient number is 200, comprising 100 patients receiving direct EVT and 100 receiving bridging therapy. Study outcome The primary efficacy endpoint is a modified Rankin Scale score of 0–2 at 90 days. Safety outcome measures are any intracranial hemorrhage at 24 h. Discussion This trial may help determine whether direct EVT should be recommended as a routine clinical strategy for ischemic stroke patients within 4.5 h from onset. Direct EVT would then become the choice of therapy in stroke centers with endovascular facilities. Trial registration UMIN000021488.

Sign in / Sign up

Export Citation Format

Share Document