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Prognosis of aphasia in stroke patients early after iv thrombolysis.

Abstract

OBJECTIVE
Stroke patients with aphasia have a high long-term morbidity. Intravenous rt-PA (iv) thrombolysis is given more deliberately to these patients. Early outcome data is lacking. Aim of this study was to determine early benefit from rt-PA in patients with aphasia.
METHODS
Data of stroke patients treated by iv thrombolysis was scrutinized for the presence of aphasia defined as ≥1 point for aphasia on the National Institute of Health Stroke Scale (NIHSS). Improvement was defined as a gain of ≥1 point within 24h. Cranial computed tomography (CT) scans were evaluated regarding early ischemic changes (EICs), infarct volume and localization.
RESULTS
Fifty patients with aphasia were included. 16 (32%) of patients improved (4 (36%) minor, 7 (41%) moderate, 5 (23%) major stroke patients), while 44 (62%) remained unchanged. Of 28 patients with EICs, 10 (36%) improved compared to 7 out of 22 (32%) patients without (p=0.773). Aphasia outcome was significantly associated with infarct volume at admission and at 24h (Kruskal-Wallis, p=0.033, p≤0.001, respectively).
CONCLUSION
EICs are not predictive of aphasia outcome and patients with improvement showed smaller infarct volumes. One third improved within 24h, while two thirds remained unchanged. This might justify a closer follow-up of aphasia in stroke patients at the acute stage.

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  • Publisher Full Text
  • Authors

    Kremer C, Perren F, Kappelin J, Selariu E, Abul-Kasim K

    Source

    Clinical neurology and neurosurgery 115:3 2013 Mar pg 289-92

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Aphasia
    Brain
    Brain Ischemia
    Cerebral Infarction
    Echocardiography, Transesophageal
    Female
    Fibrinolytic Agents
    Humans
    Injections, Intravenous
    Male
    Middle Aged
    Neurologic Examination
    Neuropsychological Tests
    Prognosis
    Risk Factors
    Sex Factors
    Stroke
    Thrombolytic Therapy
    Tissue Plasminogen Activator
    Tomography, X-Ray Computed
    Treatment Outcome

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22738732