Stroke Treatment Beyond the Three-hour Window and in the Pregnant Patient

被引:11
作者
Cronin, C. A. [1 ]
Weisman, C. J. [2 ]
Llinas, R. H. [1 ]
机构
[1] Johns Hopkins Sch Med, Dept Neurol, Baltimore, MD USA
[2] Sinai Hosp, Dept Obstet & Gynecol, Baltimore, MD 21215 USA
来源
YEAR IN NEUROLOGY 2008 | 2008年 / 1142卷
关键词
stroke; pregnancy; treatment; thrombolysis;
D O I
10.1196/annals.1444.013
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
For acute stroke patients who arrive at the hospital within 3 h of symptom onset, the focus of care involves screening for eligibility to receive intravenous tissue plasminogen activator. The publication of the National Institute of Neurological Disorders and Stroke recombinant tissue-type plasminogen activator (tPA, or alteplase) study in 1995 (Marler, J.R. 1995, New England Journal of Medicine 333: 1581-1587) spurred protocol changes, which continue to evolve, throughout the health care system in an effort to streamline the patient through the Emergency Medical System. The need to expedite patient evaluation involving emergency department, laboratory, radiology, and clinical neurology testing is clear and has been a focus of many stroke centers. For some patients, intravenous thrombolysis within 3 h has a dramatic effect on outcome. However, that is not the only course of action for acute stroke patients. This article will review some of the effective treatments for stroke patients beyond the first 3 h of their care.
引用
收藏
页码:159 / 178
页数:20
相关论文
共 128 条
[1]   Guidelines for the early management of adults with ischemic stroke - A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups [J].
Adams, Harold P., Jr. ;
del Zoppo, Gregory ;
Alberts, Mark J. ;
Bhatt, Deepak L. ;
Brass, Lawrence ;
Furlan, Anthony ;
Grubb, Robert L. ;
Higashida, Randall T. ;
Jauch, Edward C. ;
Kidwell, Chelsea ;
Lyden, Patrick D. ;
Morgenstern, Lewis B. ;
Qureshi, Adnan I. ;
Rosenwasser, Robert H. ;
Scott, Phillip A. ;
Wijdicks, Eelco F. M. .
STROKE, 2007, 38 (05) :1655-1711
[2]   Antithrombotic treatment of ischemic stroke among patients with occlusion or severe stenosis of the internal carotid artery - A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST) [J].
Adams, HP ;
Bendixen, BH ;
Leira, E ;
Chang, KC ;
Davis, PH ;
Woolson, RF ;
Clarke, WR ;
Hansen, MD .
NEUROLOGY, 1999, 53 (01) :122-125
[3]   Low molecular weight heparinoid, ORG 10172 (Danaparoid), and outcome after acute ischemic stroke - A randomized controlled trial [J].
Adams, HP ;
Woolson, RF ;
Helgason, C ;
Karanjia, PN ;
Gordon, DL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (16) :1265-1272
[4]   Massive pulmonary embolism during pregnancy successfully treated with recombinant tissue plasminogen activator - A case report and review of treatment options [J].
Ahearn, GS ;
Hadjiliadis, D ;
Govert, JA ;
Tapson, VF .
ARCHIVES OF INTERNAL MEDICINE, 2002, 162 (11) :1221-1227
[5]   Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study [J].
Albers, Gregory W. ;
Thijs, Vincent N. ;
Wechsle, Lawrence ;
Kemp, Stephanie ;
Schlaug, Gottfried ;
Skalabrin, Elaine ;
Bammer, Roland ;
Kakuda, Wataru ;
Lansberg, Maarten G. ;
Shuaib, Ashfaq ;
Coplin, William ;
Hamilton, Scott ;
Moseley, Michael ;
Marks, Michael P. .
ANNALS OF NEUROLOGY, 2006, 60 (05) :508-517
[6]   Hemorrhagic complications after off-label thrombolysis for ischemic stroke [J].
Aleu, Aitziber ;
Mellado, Patricio ;
Lichy, Christoph ;
Koehrmann, Martin ;
Schellinger, Peter D. .
STROKE, 2007, 38 (02) :417-422
[7]   Pneumonia and urinary tract infection after acute ischaemic stroke: a tertiary analysis of the GAIN International trial [J].
Aslanyan, S ;
Weir, CJ ;
Diener, HC ;
Kaste, M ;
Lees, KR .
EUROPEAN JOURNAL OF NEUROLOGY, 2004, 11 (01) :49-53
[8]  
Atallah AN, 1996, BRIT J OBSTET GYNAEC, V103, P39
[9]  
*AV PHARM INC, 2002, LOV PACK INS
[10]  
Baker BA, 1998, NEW ENGL J MED, V338, P130