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[Thrombolytic therapy in cerebral infarction].

Viktoria Varga1, Ulrike Waje-Andreassen, Halvor Naess

  • 1Nevrologisk avdeling, Haukeland universitetssykehus, 5021 Bergen, Norway. viktoria.varga@helse-bergen.no

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
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Summary

Intravenous thrombolysis for acute middle cerebral artery (MCA) stroke is effective and safe. This study of 100 patients shows good outcomes and manageable complications, supporting routine use in stroke units.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Emergency Medicine

Background:

  • Intravenous thrombolysis is the primary approved treatment for cerebral infarction.
  • Haukeland University Hospital implemented thrombolysis in 1998.
  • This study reviews the initial 100 cases of middle cerebral artery (MCA) occlusion treated with thrombolysis.

Purpose of the Study:

  • To summarize the clinical experience and outcomes of the first 100 patients treated with intravenous thrombolysis for acute MCA stroke.
  • To evaluate the effectiveness and safety of thrombolysis in a real-world clinical setting.

Main Methods:

  • Prospective data collection of patients receiving intravenous thrombolytic treatment between 1998 and 2005.
  • Registration of demographic data, risk factors, treatment timing, clinical results, and complications.
  • Assessment of patient outcomes at 3-month follow-up.

Main Results:

  • Significant clinical improvement observed in 30% of patients at 2 hours and 49% at 24 hours post-treatment.
  • Symptomatic hemorrhages occurred in 2% of cases; 3 patients required hemicraniectomy for malignant cerebral edema.
  • At 3 months, 55% of patients achieved a good outcome (independence), with a 13% mortality rate.
  • The average time from stroke onset to thrombolysis initiation decreased from 166 to 142 minutes during the study period.

Conclusions:

  • The outcomes and complication rates for these 100 acute MCA stroke patients treated with thrombolysis align with international data.
  • Intravenous thrombolysis is demonstrated to be an effective and safe treatment when administered routinely within a comprehensive stroke unit.