Japanese Journal of Stroke
Online ISSN : 1883-1923
Print ISSN : 0912-0726
ISSN-L : 0912-0726
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Indications for intravenous thrombolysis for mild ischemic stroke
Kenichiro OnoHirohiko ArimotoHidenori OkawaTakashi TakaharaShunsuke TanoueAkira Shimizu
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2016 Volume 38 Issue 6 Pages 400-406

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Abstract

Background and Purpose: The purpose of this study was to evaluate the effects of recombinant tissue plasminogen activator (rt-PA) for mild ischemic stroke (NIHSS ≤ 4) on vascular studies, and to clarify which patients with mild symptoms are candidates for intravenous thrombolysis. Methods: Eighty-three patients with NIHSS scores of 1–4 and whose intracranial vascular study was performed within rt-PA treatable time were selected. The clinical courses of 32 propensity-matched pairs of patients treated with or without intravenous rt-PA thrombolysis were investigated. Results: The NIHSS score change at 24 h and median mRS score at discharge were −1, 1 in the 32 patients with rt-PA, significantly smaller than that in matched patients without thrombolysis (0, 2), respectively. The NIHSS score change at 24 h was significantly smaller in the rt-PA group (−2), than in the non-rt-PA group (0) in patients with vessel stenosis or occlusion. No significant difference in NIHSS score change at 24 h was seen between the rt-PA group (−1) and non-thrombolysis group (0) in patients with no vessel occlusion. Conclusions: Thrombolytic therapy should be considered for cases with mild symptoms (NIHSS ≤ 4) and intracranial vessel stenosis or occlusion.

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© 2016 The Japan Stroke Society
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