Abstract
We retrospectively evaluated cases of super-acute phase cerebral infarction who were excluded from thrombolytic therapy. Seventy potential candidates for intraarterial or intravenous thrombolytic therapy were included in the present study. Forty-eight cases were men and 22 were women. Their mean age was 70.3 years old. They consulted Chiba Cardiovascular Center within 2 hours after symptom onset between April 2002 and September 2007. All of them were excluded from thrombolytic therapy because their neurological symptoms were mild or rapidly improved. The proportion of a poor prognosis (modified Rankin Scale score at discharge ≥3) and the factors related to a poor prognosis were evaluated statistically using commercially available software. Three of the 45 cases with mild neurological symptoms and 8 of the 25 cases with rapid improvement had a poor prognosis. The proportion of a poor prognosis was significantly high in the cases with rapid improvement (Fisher's exact test, p=0.0128), and no other factor was related to the poor prognosis. Exclusion from thrombolytic therapy should be undertaken with caution, if no other exclusion criterion has been found except for rapid improvement of neurological symptoms.
