2010
DOI: 10.1161/strokeaha.109.569459
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Early Recurrent Ischemic Stroke Complicating Intravenous Thrombolysis for Stroke

Abstract: Background and Purpose— Mechanisms of early neurologic deterioration after treatment with intravenous, recombinant, tissue-type plasminogen activator (IV rt-PA) include symptomatic intracerebral hemorrhage (SICH) and early recurrent ischemic stroke. We observed a number of cases of acute deterioration due to recurrent ischemic events. Methods— We undertook a single-center, retrospective analysis of consecutive ac… Show more

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Cited by 87 publications
(78 citation statements)
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“…The observed difference in baseline characteristics is common when investigating AF-related stroke outcome. 7,11,23,24 The group analysis presented here underlines the importance of adjusting for important confounders, which the previous studies have neglected.…”
Section: Discussionmentioning
confidence: 83%
“…The observed difference in baseline characteristics is common when investigating AF-related stroke outcome. 7,11,23,24 The group analysis presented here underlines the importance of adjusting for important confounders, which the previous studies have neglected.…”
Section: Discussionmentioning
confidence: 83%
“…15,16 Importantly, unexplained END represented 7% of all IV-rtPA-treated patients with AIS and more than two thirds of all-cause ENDs. Thus, the majority of ENDs have no clear underlying mechanism.…”
Section: Discussionmentioning
confidence: 99%
“…Early recurrent ischemic stroke was defined as the occurrence of new neurological symptoms suggesting the involvement of initially unaffected vascular territories and evidence of corresponding ischemic lesions on follow-up imaging, which excludes arterial reocclusion, proximal extension, or distal embolism of the original thrombus. 15,16 Thus, END unexplained was operationally defined as END without evidence for any of the above causes or other potentially causative definite medical complication (eg, poststroke seizure).…”
Section: Unexplained Endmentioning
confidence: 99%
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“…3 As we and others have shown, even a small worsening in NIHSS (as few as 2 points) has been associated with poorer prognosis when compared to patients who do not deteriorate. 3,4 Previous studies have shown the association between ND occurrence and stroke severity on admission, 5,6 the presence of large vessel occlusion, [7][8][9] history of coronary artery disease or myocardial infarction, 1,7 diabetes mellitus, 1,7,9,10 acute or chronic hyperglycemia, 1,7,11-13 elevated blood pressure, 13,14 as well as early recurrent ischemic stroke 15 and symptomatic intracranial hemorrhage (sICH). 11,16 While it has been shown that nearly one-half of ND patients deteriorate within the first 24-48 hours of the stroke, 1,[17][18][19] no study has described time to ND or investigated factors affecting time to ND.…”
Section: Introductionmentioning
confidence: 99%