Intravenous thrombolysis in stroke mimics: results from the SITS International Stroke Thrombolysis Register

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
B KeselmanMichael V Mazya

Abstract

Patients with stroke mimics (SM), i.e. conditions with stroke-like symptoms, may risk harm if treated with intravenous thrombolysis (IVT). Current guidelines state low risk of intracerebral hemorrhage based on studies comprising a total of <400 SM cases. We aimed to compare safety and outcomes following IVT between patients with acute ischaemic stroke and mimicking conditions. We included IVT-treated ischaemic stroke patients in the SITS International Stroke Thrombolysis Register 2003-2017, examined with magnetic resonance imaging 22-36 h after treatment. Outcomes were parenchymal hematoma (PH) after treatment, symptomatic intracerebral hemorrhage (SICH) per Safe Implementation of Thrombolysis in Stroke Monitoring Study (SITS-MOST), Second European Co-operative Stroke Study (ECASS II) and National Institutes of Neurological Disorders and Stroke Study (NINDS) criteria, death and modified Rankin Scale score (mRS) at 3 months. Of 10 436 patients, 429 mimics (4.1%) were identified. The most common types were functional (30.8%), migraine (17.5%) and seizure (14.2%). Patients with mimics had fewer cerebrovascular risk factors and lower median National Institutes of Health Stroke Scale score [7 (interquartile range, 5-10) vs. 8 (5-14)...Continue Reading

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Citations

Dec 6, 2018·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Noreen KamalJennifer Bestard
Nov 5, 2019·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
Apr 17, 2020·Stroke; a Journal of Cerebral Circulation·Stoyan PopkirovAlastair M Buchan
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Jun 9, 2020·Frontiers in Neurology·Håkan AlmqvistMichael V Mazya
Feb 6, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Klearchos PsychogiosGeorgios Tsivgoulis
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Apr 1, 2021·Expert Review of Neurotherapeutics·Shadi El-WahshCandice Delcourt
Apr 4, 2021·Journal of Clinical Medicine·Jordi Kühne EscolàJan C Purrucker
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Nov 21, 2021·Current Opinion in Neurology·Klearchos Psychogios, Georgios Tsivgoulis

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