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Angiography 16 to 24 hours after treatment in 17 patients showed patent intracranial arteries in 12,partial occlusion of the middle cerebral artery in 3,and total occlusion of the middle cerebral artery in 2.rCBF with Tc-hexamethylpropyleneamine oxime intravenously was measured 5 minutes before and within 24 hours after thrombolytic therapy in 12 patients.10 of the 12 patients showed brain tissue reperfusion and 2,with angiographically documented middle cerebral artery occlusion,showed no reperfusion,thus documenting a relationship between reperfusion measured by regional cerebral blood flow and angiographic patency(P=.015).Three patients died.Patients who were reperfused within 24 hours(documented by repeated regional cerebral blood flow measurements)showed greater clinical improvement on the Scandinavian Stroke Scale the sooner their thrombolytic therapy was started and the more severe their neurological deficits.Acute cerebral ischemia can be documented by rCBF measurements without delay of thrombolytic therapy,and repeated rCBF measurements can reveal whether cerebral reperfusion has occurred.In our study,early reperfusion was associated with clinical improvement. |
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