Which Patients with Acute Stroke Don't Need Thrombolysis?

An observational study suggests that small CT perfusion deficits do not require treatment, but the evidence should not yet change practice.

Whether patients with mild clinical deficits benefit from intravenous tissue plasminogen activator (TPA) treatment after presentation with an acute ischemic stroke has been debated. Now, researchers have addressed a related question: Do patients with “radiologically mild” acute ischemic stroke presentation benefit from TPA? These authors analyzed outcomes of such patients who had multimodal computed tomography (CT) scanning performed before the thrombolytic decision was made. The CT protocol included CT angiography (CTA) and CT perfusion (CTP) studies. The analysis focused on 366 patients with a small ischemic volume (CTP volume ≤15 mL). Median National Institutes of Health Stroke Scale score was 8. At the clinician's discretion, 212 patien…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Which Patients with Acute Stroke Don't Need Thrombolysis?

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Reviewing Author