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[A retrospective study of potential benefits of thrombolytic drugs in a stroke]
A Gironell1, F Barón, J L Martí-Vilalta
1Servei de Neurologia, Hospital de la Santa Creu i Sant Pau, Barcelona.
Insights
Thrombotic drugs may benefit approximately 23% of ischemic stroke patients, particularly those with cardioembolic causes and severe symptoms. Careful patient selection is crucial due to common exclusion criteria for this stroke treatment.
Area of Science:
- Neurology
- Vascular Medicine
Abstract:
We carried out a retrospective analysis into the possible uses of thrombotic drugs on 190 consecutive patients with ischaemic stroke who had been admitted to the Neurological Service of the Barcelona 'Hospital de la Santa Creu i Sant Pau' in accordance with exclusion criteria commonly accepted for the use of this type of medication. We thus analyzed the initial symptoms, type of instauration, etiological diagnosis and topographical diagnosis. In those patients who could be possible candidates for such treatment with these drugs we assessed their disability variations (on the Rankin scale) at the end of two weeks using currently available therapeutic means. 70% of patients would subsequently be excluded from our study. Among reasons for exclusion were especially minor neurological deficiencies, age and latency time. As for patients included, most predominant factors were immediate instauration, cardioembolic etiological mechanism and severe onset symptomatology (motor disorder, awareness and language abnormalities). We observed a substantial spontaneous improvement in 7% of patients. This fact is especially clear in cardioemboligenic etiology patients. Bearing the spontaneous improvement cases in mind, we concluded that some 23% of patients with ischaemic cerebrovascular pathology could benefit from thrombotic drugs in our milieu.