Background-Recombinant tissue plasminogen activator (rTPA) is an established treatment for acute ischemic stroke. The rate and type of protocol violations in rTPA use and their effect on patient outcomes in this setting are not well understood. Objective-The objective of this study was to examine associations between protocol violations and outcomes in community-based rTPA use. Methods-We reviewed medical records of stroke patients treated with rTPA in 10 acute-care hospitals in Indianapolis from July 1996 to February 1998 and assessed complications and outcome. Retrospective National Institute of Health Stroke Scale (on admission and discharge), Canadian Neurological Scale, and length of hospital stay were calculated.

URL: http://www.clinicaltrials.gov. Unique identifier: NCT01994720.

No abstract

A patient is described, who developed blepharospasm secondary to a cortical ischemic lesion in the region of the right anterior cerebral artery. Blepharospasm started as an increased blinking rate in the contralateral eye, and slowly progressed to sustained bilateral orbicularis oculi contractions, which were more severe on the contralateral side. Abnormal blink reflexes suggest a disinhibited excitatory drive to the facial nucleus. Our case warrants the inclusion of blepharospasm in the list of eyelid abnormalities secondary to cerebrovascular hemispheric lesions.