DWI/FLAIR mismatch based intravenous thrombolysis in acute stroke patients with unknown onset time

Abstract

Acute stroke patients whose events occurred in an unknown time frame were treated with intravenous thrombolysis when showing DWI/FLAIR mismatch. From June 2009 to October 2011, 13 patients [83 (67-90) years; NIHSS score, 16 (11-20)] were enrolled. Interval between last known normal time and thrombolysis was 5.6 (5.0-11.6) h. Recanalization within 24 h was seen in 10 patients (complete, n=5). None of the patients experienced symptomatic cerebral hemorrhage. At day 7, 7 patients showed dramatic recovery (≥10-point reduction in NIHSS score or of 0-1). At 3 months, 5 patients had mRS score of 0-2. Stroke patients with DWI/FLAIR mismatch may be able to safely receive intravenous thrombolysis.