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Ischemic cerebral infarction(CI)is a serious complication of acute myocardial infarction(MI).Little information exists on CI after thrombolytic therapy for MI.Age range was 40 to 74 years,(mean 60 years); 25 patients(86%)were white.The electrocardiographic location of MI was anterior in 22(76%),and nonanterior in 7(24%).Five CI's occurred within 6 hours,4 between 6 and 24 hours,8 during the remainder of the first week,10 during the second week,and 2 others distributed over the 4 weeks after study entry.Six of the 29 CI's did not involve the cerebral cortex;9 patients(31%)had multiple CI's.Of 28 CIs thought to be embolic in origin, 17 showed strong evidence for at least one cardiac abnormality(mural clot, wall motion abnormality,aneurysm,or atrial fibrillation)known to be associated more specifically with embolism than MI.Eight of 27 CIs(30%) with CT scans had hemorrhagic transformation of varying degrees;5 were asymptomatic.The time of occurrence and sites of CI after rt-PA and heparin therapy for acute MI are similar to those reported during the prethrombolytic era. |
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anticoagulant,treatment
cerebral infarction
cerebrovascular accident
fibrinolytic agents
fibrinolytic agents,complications
heparin
myocardial infarction
myocardial infarction,acute
risk factors
tissue plasminogen activator,intravenous
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