کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3249057 1589165 2012 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Use of Emergency Department Transcranial Doppler Assessment of Reperfusion After Intravenous tPA for Ischemic Stroke
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی طب اورژانس
پیش نمایش صفحه اول مقاله
Use of Emergency Department Transcranial Doppler Assessment of Reperfusion After Intravenous tPA for Ischemic Stroke
چکیده انگلیسی

Background: Thrombolysis with intravenous recombinant tissue plasminogen activator (IV-tPA) has been associated with significant improvements in clinical outcomes when initiated within 3 h of symptom onset. Although adjunctive therapies for acute stroke have been developed, challenges remain in identifying appropriate patients and therapeutic end-point measurements. Objective: To describe the use of transcranial Doppler (TCD) monitoring in the Emergency Department (ED) to guide the decision for advanced reperfusion strategies after failure of IV-tPA. Case Report: A 75-year-old man presented to the ED within 50 min after the acute onset of right-sided hemiparesis and aphasia. After administration of IV-tPA, there was no immediate improvement in neurological symptoms. TCD performed in the ED demonstrated persistent left middle cerebral artery (MCA) occlusion. Based on this information, the patient received intra-arterial tPA followed by mechanical thrombectomy of the MCA occlusion, resulting in clinical improvement of the patient's right hemiparesis and aphasia. Conclusion: TCD is a feasible assessment tool for use in the ED to aid in diagnosis and to guide treatment decisions in patients with acute ischemic stroke, including those not responding to IV-tPA therapy.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Emergency Medicine - Volume 42, Issue 1, January 2012, Pages 40–43
نویسندگان
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