Safety of tPA in stroke mimics and neuroimaging-negative cerebral ischemia

• DOI: 10.1212/wnl.0b013e3181dad5a6
• Publication Date: 2010-03-25T03:59:16Z
• Authors: O.Y. Chernyshev; S. Martin-Schild; K.C. Albright; A. Barreto; V. Misra; I. Acosta; J.C. Grotta; S.I. Savitz
• Keywords: Stroke; Etiology

Patients with acute neurologic symptoms may have other causes simulating ischemic stroke, called stroke mimics (SM), but they also averted strokes that do not appear as infarcts on neuroimaging, which we call neuroimaging-negative cerebral ischemia (NNCI). We determined the safety and outcome of IV thrombolysis within 3 hours symptom onset in patients SM NNCI.Patients treated tissue plasminogen activator (tPA) were identified from our registry June 2004 to October 2008. collected admission NIH Stroke Scale (NIHSS) score, modified Rankin score (mRS), length stay (LOS), symptomatic intracerebral hemorrhage (sICH), discharge diagnosis.Among 512 patients, 21% found an infarct follow-up imaging. In group (14%), average age was 55 years, median NIHSS 7, 0, LOS days, there no instances sICH. The most common etiologies seizure, complicated migraine, conversion disorder. NNCI (7%), 61 Nearly all (87%) (91%) functionally independent (mRS 0-1).Our data support administering suspected onset, even when diagnosis ultimately is be or imaging does show infarct.