抄録
Background: The appearance of extensive early computed tomography (CT) signs is considered as a contraindication for thrombolytic therapy. However, to date, no report has been published on the timing of the appearance of CT signs. We therefore investigated the time after onset until the appearance of early CT signs in patients with middle cerebral artery (MCA) trunk or common carotid artery (CCA)/internal carotid artery (ICA) embolisms. Methods: The time from onset until an initial CT scan, the subtypes of ischemic stroke and the appearance of early CT signs were investigated in early ischemic stroke patients with lesions of the CCA/ICA or MCA trunk who had been transported to our emergency and critical care center between 2002 and 2007. Results: A total of 104 patients (CCA/ICA, n=23; MCA trunk, n=81) were examined. The results indicated that the rate of the appearance of early CT signs was 0% at less than 0.5 hours after onset; on the other hand, the rate was 100% at 1.5-2 h and 2-3 h after outset. A significant difference in the timing of the initial CT brain scan (p<0.0001 Wilcoxon test) was seen between the group without early CT signs (n=37) and the group with early CT signs (n=67). The boundary line between the two groups apparently occurred 0.5-1.0 hours after the onset period. Thus, most early CT signs appeared 0.5-1.0 hours after onset (p<0.0001 Wilcoxon test). Conclusions: The present results could be useful when making decisions regarding the timing of thrombolytic therapy.
