Early Neurologic Improvement Tied to Good Outcome Later

Ischemic stroke patients undergoing recombinant tissue plasminogen activator perfusion studied

TUESDAY, Nov. 9 (HealthDay News) -- Patients with acute ischemic stroke (AIS) who demonstrate very early neurologic improvement (VENI) after intravenous (IV) recombinant tissue plasminogen activator (rt-PA) perfusion are likely to have favorable outcomes at three months, according to a study in the November issue of the Archives of Neurology.

In a retrospective analysis of prospective data, Ioan-Paul Muresan, M.D., of the Assistance Publique-Hôpitaux de Paris, and colleagues evaluated 120 consecutive patients with AIS treated with IV rt-PA between Nov. 11, 2002, and Dec. 24, 2007.

The investigators found that 22 patients (18.3 percent) had VENI after IV rt-PA perfusion, including 15 patients (68.2 percent) who experienced favorable outcomes. The investigators also found that 29 patients without VENI (29.6 percent) experienced favorable outcomes. The mortality rate was 0 percent among patients who had VENI, with none of these patients experiencing symptomatic intracerebral hemorrhage. The mortality rate was 17.3 percent in patients without VENI. The only two factors associated with favorable outcome were baseline scores for VENI and the National Institute of Health Stroke Scale.

"Clearly, additional studies involving larger populations with a multicenter design are needed to address the significance and clinical utility of the intriguing findings of this carefully conducted study by Muresan and colleagues," writes the author of an accompanying editorial.

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