Quatro anos de experiência no tratamento trombolítico do AVC Isquêmico na cidade de Porto Alegre

Abstract

Embora o benefício do tratamento trombolítico no AVC isquêmico esteja bem demonstrado, o impacto na população geral de pacientes com AVC ainda é limitado, principalmente devido a estreita janela terapêutica. No Brasil, poucos centros estão estruturados para o uso do rtPA no AVC isquêmico agudo. Nós apresentamos os resultados de 4 anos de experiência em terapia trombolítica, com 173 pacientes tratados em 3 Unidades Vasculares implementadas em hospitais gerais no Sul do Brasil.

Comparação da severidade do déficit neurológico de pacientes com acidente vascular cerebral isquêmico agudo submetidos ou não à terapia trombolítica

“…Some authors defend the thrombolytic treatment, regardless the patient age or the stroke severity 19 , whereas others show a proportional increase in the hemorrhagic transformation 9 . However, a consensus was not reached on the importance of early treatment as indispensable for obtaining any benefit [6][7][8][9]19,21,22 .…”

“…The hemorrhagic transformation rate was only 6.3%. The early treatment with a short therapeutic window of only 2.5 hours and the fact that the most severe cases of thrombolytic treatment were excluded may have contributed to these positive results 21 . Gouveia 22 investigated 14 patients under treatment with thrombolytic therapeutic window of 3 hours and observed reduction in more than five points in the NIHSS, without any occurrence of cerebral hemorrhage.…”

“…The hemorrhagic transformation seems to be related to ages over 80 years, to the stroke severity and to SAH above the levels of 185/110 in the first 24 hours after the thrombolysis 23 . The fact is that several studies associate the early alteplase infusion with the reduction in hemorrhages, the effective reduction in disabilities and the good functional results [6][7][8][9]18,21,22 .…”

Evaluation of Respiratory Muscle Strength in the Acute Phase of Stroke: The Role of Aging and Anthropometric Variables

“…In the acute phase of stroke, inhibition of the cortical activity contributes to the reduction of motor control, hemiplegia, and weakness of the trunk muscles, mainly of the diaphragm and abdominal muscle. [19][20][21][22] The abdominal muscles play an important role during inspiration, contributing directly to the action of the diaphragm for the maintenance of abdominal wall tonus. The increase in abdominal pressure developed during inspiration is transmitted to the lower rib cage by the apposing diaphragmatic fibers and may, therefore, improve the ability of the diaphragm to raise the lower rib cage.…”