BACKGROUND AND PURPOSE Compared with other stroke causes, small-vessel disease is associated with better 3-month outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. Another question is the impact of coexisting cerebral white matter lesions (WMLs; a surrogate marker of small-vessel disease) on outcome, which was addressed in the current study. METHODS We anal...

BACKGROUND AND PURPOSE The present study determines associations between early blood pressure (BP) variability and stroke outcomes after intravenous thrombolysis. METHODS In 527 stroke patients receiving intravenous alteplase (0.6 mg/kg), BP was measured 8 times within the first 25 hours. BP variability was determined as ΔBP (maximum-minimum), standard deviation (SD), coefficient of variation...

Patients waking-up with symptoms of stroke or in whom no witness is available and time from last time the patient was seen normal is >4.5 hours represent a specific subgroup of stroke patients. Unknown onset (UKO) of stroke is quite frequent and affecting ≈≤25% of acute stroke patients. Given that the exact time point of symptom onset is unknown but may exceed 4.5 hours, this large group of pat...

Intravenous thrombolysis (IVT) with alteplase remains the standard treatment for acute ischemic stroke. Although IVT can be started up to 4.5 hours after symptoms' onset, it is all the more effective and safe when started early. It allows a 10% absolute reduction in the risk of handicap or death at 3 months, despite a 2-7% risk of symptomatic intracranial hemorrhage. Current research efforts in...

Abbreviations: APTT 5 activated partial thromboplastin time; ASSENT 5 Asessment of the Safety and Efficacy of a New Thrombolytic Agent; CI 5 confidence interval; FTT 5 Fibrinolytic Therapy Trialists’ Collaborative Group; GISSI 5 Gruppo Italiano per lo Studio Streptokinasi nell’Infarto Miocardico; GP 5 glycoprotein; GUSTO 5 Global Utilization of Streptokinase and TPA (alteplase) for Occluded Cor...

After intravenous recombinant tissue-type plasminogen activator (IV-rtPA) for acute ischemic stroke (AIS), clinical evolution in the first 24 hours is largely unpredictable, underlying the need to better investigate this time window. Although the majority of patients with AIS substantially improve after IV-rtPA, a fraction experience early neurological deterioration (END). Because END consisten...

Endovascular therapy (EVT) has revolutionized the treatment of acute ischemic stroke. In past few years, endovascular indications have expanded to include patients being treated in extended window, with large core infarction, basilar artery occlusion (BAO) thrombectomy, as demonstrated by several randomized clinical trials. Intravenous thrombolysis (IVT) bridging mechanical thrombectomy also be...

BACKGROUND AND OBJECTIVES Although data are absent, it has been stated that thrombolysis is probably not safe in the treatment of acute stroke in patients undergoing hemodialysis. The objective of this study was for stroke experts to define the range of management concerning thrombolytic treatment of acute stroke in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Sixty-five stroke...

Intravenous thrombolysis (IVT) with tissue-type plasminogen activator demonstrated efficacy and safety for the treatment of acute ischemic stroke for almost 20 years. Nevertheless, IVT is still underutilized. A multitude of exclusion criteria reflects the fear for intracranial hemorrhage (ICH) and limits the widespread use of IVT. However, in recent years, several registry-based studies showed ...

BACKGROUND AND PURPOSE Efficacy of intravenous thrombolysis in acute ischemic stroke declines with increasing time to treatment initiation. Previous small-scale studies suggested that the earlier patients arrive, the longer it takes to administer recombinant tissue plasminogen activator. METHODS Of 32 529 patients with stroke prospectively enrolled in the Austrian Stroke Unit Registry (2004 t...