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Intravenous Tissue-Type Plasminogen Activator for Treatment of Acute Stroke
JAMA 283:1145-1150,1189, Albers,G.W.,et al, 2000
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Article Abstract
Thirteen patients (3.3%) experienced symptomatic intracerebral hemorrhage, including 7 who died. Twenty-eight patients (8.2%) had asymptomatic intracerebral hemorrhage within 3 days of treatment with tPA. Protocol violations were report ed for 127 patients (32.6%), and included treatment with tPA more than 3 hours after symptom onset in 13.4%, treatment with anticoagulants within 24 hours of tPA administration in 9.3%, and tPA administration despite systolic blood pressure exceeding 185m m Hg in 6.7%. A multivariate analysis found predictors of favorable outcome to be less severe baseline National Institutes of Health Stroke Scale score, absence of specific abnormalities (effacement or hypodensity of >33% of the middle cerebral artery te rritory of a hyperdense middle cerebral artery) on the baseline computed tomographic scan, an age of 85 years or younger, and a lower mean arterial pressure at baseline. This study, conducted at multiple institutions throughout the United States, suggest s that favorable clinical outcomes and low rates of symptomatic intracerebral hemorrhage can be achieved using tPA for stroke treatment.
 
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adverse drug reaction
cerebrovascular accident
cerebrovascular accident,acute management of
cerebrovascular accident,thrombolytic agents in treatment
fibrinolytic agents
fibrinolytic agents,complications
intracerebral hemorrhage
prognosis
protocol violations
review article
tissue plasminogen activator,intravenous
treatment of neurologic disorder

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