Yıl 2025,
Cilt: 16 Sayı: 1, 34 - 37, 28.03.2025
Ahmad Luqman Md Pauzi
,
Juliana Hashim
Kaynakça
- 1. Werner Hacke, M.D., Markku Kaste, M.D., Erich Bluhmki, Ph.D., Miroslav Brozman, M.D., Antoni Dávalos, M.D., Donata Guidetti, M.D., Vincent Larrue, M.D., Kennedy R. Lees, M.D., Zakaria Medeghri, M.D., Thomas Machnig, M.D., Dietmar Schneider, M.D., Rüdiger von Kummer, M.D., et al. Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke. N Engl J Med 2008; 359:1317-1329
- 2. Krassen Nedeltchev, Benjamin Schwegler, Tobias Haefeli, Caspar Brekenfeld, Jan Gralla, Urs Fischer, Marcel Arnold, Luca Remonda, Gerhard Schroth, and Heinrich P. Mattle. Outcome of Stroke With Mild or Rapidly Improving Symptoms. Stroke. 2007;38:2531–2535
- 3. Urs Fischer, Adrian Baumgartner, Marcel Arnold, Krassen Nedeltchev, Jan Gralla, Gian Marco De Marchis, Liliane Kappeler, Marie-Luise Mono, Caspar Brekenfeld, Gerhard Schroth, and Heinrich P. Mattle. What Is a Minor Stroke? Stroke. 2010;41:661–666
- 4. NIH Stroke Scale (NIHSS). NIH stroke scale International; 1999; http://www.nihstrokescale.org/.
- 5. Casella G, Llinas RH, Marsh EB. Isolated aphasia in the emergency department: The likelihood of ischemia is low. Clin Neurol Neurosurg. 2017 Dec;163:24-26.
- 6. Nesi M, Lucente G, Nencini P, Fancellu L, Inzitari D. Aphasia predicts unfavorable outcome in mild ischemic stroke patients and prompts thrombolytic treatment. J Stroke Cerebrovasc Dis. 2014 Feb;23(2):204-8.
- 7. Ilana Spokoyny, MD, Rema Raman, PhD, Karin Ernstrom, MS, Pooja Khatri, MD, MSc, Dawn M. Meyer, PhD, RN, FNP-C, Thomas M. Hemmen, MD, PhD, and Brett C. Meyer, MD Defining Mild Stroke: Outcomes Analysis of Treated and Untreated Mild Stroke Patients. J Stroke Cerebrovasc Dis. 2015 June ; 24(6): 1276–1281.
- 8. Sato S, Uehara T, Ohara T, Suzuki R, Toyoda K, Minematsu K. Factors associated with unfavorable outcome in minor ischemic stroke. Neurology, 06 Jun 2014, 83(2):174-181.
- 9. Mirjam R. Heldner, Panagiotis Chaloulos-Iakovidis, Leonidas Panos, Bastian Volbers, Johannes Kaesmacher, Tomas Dobrocky, Pasquale Mordasini, Marwan El-Koussy, Jan Gralla, Marcel Arnold, Urs Fischer, Heinrich P. Mattle & Simon Jung. Outcome of patients with large vessel occlusion in the anterior circulation and low NIHSS score. Journal of Neurology volume 267, pages 1651–1662(2020).
- 10. Köhrmann M. Nowe T. Huttner H.B Engelhorn T. Struffert T• Kollmar R• Saake M• Doerfler A • Schwab S• Schellinger P.D Safety and Outcome after Thrombolysis in Stroke Patients with Mild Symptoms. Cerebrovasc Dis 2009; 27:160–166.
- 11. Matthias Wendt, Serdar Tütüncü, Jochen B Fiebach, Jan F Scheitz, Heinrich J Audebert, Christian H Nolte. Preclusion of ischemic stroke patients from intravenous tissue plasminogen activator treatment for mild symptoms should not be based on low National Institutes of Health Stroke Scale Scores. J Stroke Cerebrovasc Dis 2013 May;22(4):550-3.
- 12. Maas MB, Lev MH, Ay H, Singhal AB, Greer DM, Smith WS, et al: The prognosis for aphasia in stroke. J Stroke Cerebrovasc Dis 2012; 21:350–357.
- 13. Nesi M, Lucente G, Nencini P, Fancellu L, Inzitari D: Aphasia predicts unfavorable outcome in mild ischemic stroke patients and prompts thrombolytic treatment. J Stroke Cerebrovasc Dis 2014;23:204–208.
- 14. C Denier, O Chassin, C Vandendries, L Bayon de la Tour, C Cauquil, M Sarov, D Adams, C Flamand-Roze. Thrombolysis in Stroke Patients with Isolated Aphasia. Cerebrovasc Dis 2016;41(3-4):163-9.
- 15. Kremer, C., Kappelin, J., & Perren, F. (2014). Dissociation of severity of stroke and aphasia recovery early after intravenous recombinant tissue plasminogen activator thrombolysis. Journal of Clinical Neuroscience, 21(10), 1828–1830. doi:10.1016/j.jocn.2014.01.010
- 16. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. William J. Powers, MD, FAHA, Chair, Alejandro A. Rabinstein, MD, FAHA, Vice Chair, Teri Ackerson, BSN, RN, Opeolu M. Adeoye, MD, MS, FAHA, Nicholas C. Bambakidis, MD, FAHA, Kyra Becker, MD, FAHA, José Biller, MD, FAHA, Michael Brown, MD, MSc, Bart M. Demaerschalk, MD, MSc, FAHA, Brian Hoh, MD, FAHA, Edward C. Jauch, MD, MS, FAHA, Chelsea S. Kidwell, MD, FAHA, Thabele M. Leslie-Mazwi, MD, Bruce Ovbiagele, MD, MSc, MAS, MBA, FAHA, Phillip A. Scott, MD, MBA, FAHA, Kevin N. Sheth, MD, FAHA, Andrew M. Southerland, MD, MSc, FAHA, Deborah V. Summers, MSN, RN, FAHA, David L. Tirschwell, MD, MSc, FAHA, on behalf of the American Heart Association Stroke Council
Importance of Recombinant Tissue Plasminogen Activator (rt-PA) thrombolysis in hyperacute stroke patients with aphasia – A case report
Yıl 2025,
Cilt: 16 Sayı: 1, 34 - 37, 28.03.2025
Ahmad Luqman Md Pauzi
,
Juliana Hashim
Öz
Background: Thrombolysis in an acute stroke has been shown to have a good outcome measure in an eligible candidate. However, the benefits and effectiveness of it in acute minor stroke are still not well established.
Case description: We describe a case of 35-year-old male who was presented with isolated aphasia with the total National Institutes of Health Stroke Scale of 3 out of 42. Magnetic Resonance Imaging of the brain showed a focal left middle cerebral artery territory infarction secondary to distal vessel occlusion at M4 segment distally on Diffusion-Weighted Imaging sequence which was mismatched on Fluid-Attenuated Inversion Recovery sequence. Recombined tissue plasminogen activator was administrated intravenously without any complication. The patient's condition improved gradually with positive outcome measures.
Conclusion: Intravenous r-TPA can be a beneficial treatment for a subset of patients with minor stroke.
Kaynakça
- 1. Werner Hacke, M.D., Markku Kaste, M.D., Erich Bluhmki, Ph.D., Miroslav Brozman, M.D., Antoni Dávalos, M.D., Donata Guidetti, M.D., Vincent Larrue, M.D., Kennedy R. Lees, M.D., Zakaria Medeghri, M.D., Thomas Machnig, M.D., Dietmar Schneider, M.D., Rüdiger von Kummer, M.D., et al. Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke. N Engl J Med 2008; 359:1317-1329
- 2. Krassen Nedeltchev, Benjamin Schwegler, Tobias Haefeli, Caspar Brekenfeld, Jan Gralla, Urs Fischer, Marcel Arnold, Luca Remonda, Gerhard Schroth, and Heinrich P. Mattle. Outcome of Stroke With Mild or Rapidly Improving Symptoms. Stroke. 2007;38:2531–2535
- 3. Urs Fischer, Adrian Baumgartner, Marcel Arnold, Krassen Nedeltchev, Jan Gralla, Gian Marco De Marchis, Liliane Kappeler, Marie-Luise Mono, Caspar Brekenfeld, Gerhard Schroth, and Heinrich P. Mattle. What Is a Minor Stroke? Stroke. 2010;41:661–666
- 4. NIH Stroke Scale (NIHSS). NIH stroke scale International; 1999; http://www.nihstrokescale.org/.
- 5. Casella G, Llinas RH, Marsh EB. Isolated aphasia in the emergency department: The likelihood of ischemia is low. Clin Neurol Neurosurg. 2017 Dec;163:24-26.
- 6. Nesi M, Lucente G, Nencini P, Fancellu L, Inzitari D. Aphasia predicts unfavorable outcome in mild ischemic stroke patients and prompts thrombolytic treatment. J Stroke Cerebrovasc Dis. 2014 Feb;23(2):204-8.
- 7. Ilana Spokoyny, MD, Rema Raman, PhD, Karin Ernstrom, MS, Pooja Khatri, MD, MSc, Dawn M. Meyer, PhD, RN, FNP-C, Thomas M. Hemmen, MD, PhD, and Brett C. Meyer, MD Defining Mild Stroke: Outcomes Analysis of Treated and Untreated Mild Stroke Patients. J Stroke Cerebrovasc Dis. 2015 June ; 24(6): 1276–1281.
- 8. Sato S, Uehara T, Ohara T, Suzuki R, Toyoda K, Minematsu K. Factors associated with unfavorable outcome in minor ischemic stroke. Neurology, 06 Jun 2014, 83(2):174-181.
- 9. Mirjam R. Heldner, Panagiotis Chaloulos-Iakovidis, Leonidas Panos, Bastian Volbers, Johannes Kaesmacher, Tomas Dobrocky, Pasquale Mordasini, Marwan El-Koussy, Jan Gralla, Marcel Arnold, Urs Fischer, Heinrich P. Mattle & Simon Jung. Outcome of patients with large vessel occlusion in the anterior circulation and low NIHSS score. Journal of Neurology volume 267, pages 1651–1662(2020).
- 10. Köhrmann M. Nowe T. Huttner H.B Engelhorn T. Struffert T• Kollmar R• Saake M• Doerfler A • Schwab S• Schellinger P.D Safety and Outcome after Thrombolysis in Stroke Patients with Mild Symptoms. Cerebrovasc Dis 2009; 27:160–166.
- 11. Matthias Wendt, Serdar Tütüncü, Jochen B Fiebach, Jan F Scheitz, Heinrich J Audebert, Christian H Nolte. Preclusion of ischemic stroke patients from intravenous tissue plasminogen activator treatment for mild symptoms should not be based on low National Institutes of Health Stroke Scale Scores. J Stroke Cerebrovasc Dis 2013 May;22(4):550-3.
- 12. Maas MB, Lev MH, Ay H, Singhal AB, Greer DM, Smith WS, et al: The prognosis for aphasia in stroke. J Stroke Cerebrovasc Dis 2012; 21:350–357.
- 13. Nesi M, Lucente G, Nencini P, Fancellu L, Inzitari D: Aphasia predicts unfavorable outcome in mild ischemic stroke patients and prompts thrombolytic treatment. J Stroke Cerebrovasc Dis 2014;23:204–208.
- 14. C Denier, O Chassin, C Vandendries, L Bayon de la Tour, C Cauquil, M Sarov, D Adams, C Flamand-Roze. Thrombolysis in Stroke Patients with Isolated Aphasia. Cerebrovasc Dis 2016;41(3-4):163-9.
- 15. Kremer, C., Kappelin, J., & Perren, F. (2014). Dissociation of severity of stroke and aphasia recovery early after intravenous recombinant tissue plasminogen activator thrombolysis. Journal of Clinical Neuroscience, 21(10), 1828–1830. doi:10.1016/j.jocn.2014.01.010
- 16. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. William J. Powers, MD, FAHA, Chair, Alejandro A. Rabinstein, MD, FAHA, Vice Chair, Teri Ackerson, BSN, RN, Opeolu M. Adeoye, MD, MS, FAHA, Nicholas C. Bambakidis, MD, FAHA, Kyra Becker, MD, FAHA, José Biller, MD, FAHA, Michael Brown, MD, MSc, Bart M. Demaerschalk, MD, MSc, FAHA, Brian Hoh, MD, FAHA, Edward C. Jauch, MD, MS, FAHA, Chelsea S. Kidwell, MD, FAHA, Thabele M. Leslie-Mazwi, MD, Bruce Ovbiagele, MD, MSc, MAS, MBA, FAHA, Phillip A. Scott, MD, MBA, FAHA, Kevin N. Sheth, MD, FAHA, Andrew M. Southerland, MD, MSc, FAHA, Deborah V. Summers, MSN, RN, FAHA, David L. Tirschwell, MD, MSc, FAHA, on behalf of the American Heart Association Stroke Council