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Dissociation of severity of stroke and aphasia recovery early after intravenous recombinant tissue plasminogen activator thrombolysis.

Kremer, Christine LU ; Kappelin, Johan and Perren, Fabienne (2014) In Journal of Clinical Neuroscience 21(10). p.1828-1830
Abstract
Clinical observation suggested to us that aphasia recovers relatively better than other deficits early after intravenous recombinant tissue plasminogen activator (IV-rtPA) treatment in stroke patients with minor deficits, while the reverse seemed the case in those with severe deficits. Retrospective analysis of acute ischemic stroke patients with aphasia admitted within 3hours from symptom onset and treated with IV-rtPA was carried out. Stroke severity, aphasia and global neurological impairment were assessed at admission and 24hours after thrombolysis. Improvement of aphasia (gain of ⩾1 point on the National Institutes of Health Stroke Scale [NIHSS] aphasia score) and global neurological improvement (gain of ⩾4 points on the NIHSS) were... (More)
Clinical observation suggested to us that aphasia recovers relatively better than other deficits early after intravenous recombinant tissue plasminogen activator (IV-rtPA) treatment in stroke patients with minor deficits, while the reverse seemed the case in those with severe deficits. Retrospective analysis of acute ischemic stroke patients with aphasia admitted within 3hours from symptom onset and treated with IV-rtPA was carried out. Stroke severity, aphasia and global neurological impairment were assessed at admission and 24hours after thrombolysis. Improvement of aphasia (gain of ⩾1 point on the National Institutes of Health Stroke Scale [NIHSS] aphasia score) and global neurological improvement (gain of ⩾4 points on the NIHSS) were compared in minor strokes (NIHSS ⩽7), moderate strokes (NIHSS 8-15), and major strokes (NIH ⩾16). Sixty-nine of 243 stroke patients suffered from aphasia. Improvement of aphasia occurred in 7/16 minor strokes, 11/25 moderate strokes, and 7/28 severe strokes. Improvement of ⩾4 points on the NIHSS occurred in 3/16 minor strokes, 17/25 moderate strokes and 15/28 severe strokes. There is a significant (X(2)=4.073, p<0.05) dissociation of recovery of aphasia and that of other neurological deficits between minor versus severe strokes. This confirms the clinically suspected dissociation between a good early recovery from aphasia in minor strokes relative to recovery of other neurological deficits, as opposed to a better recovery from other neurological deficits than from aphasia in patients with severe strokes. (Less)
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author
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type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Neuroscience
volume
21
issue
10
pages
1828 - 1830
publisher
Elsevier
external identifiers
  • pmid:24852905
  • wos:000342477300036
  • scopus:84908545173
ISSN
1532-2653
DOI
10.1016/j.jocn.2014.01.010
language
English
LU publication?
yes
id
d68b9263-503f-4f75-8e67-047d5f36793d (old id 4452746)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24852905?dopt=Abstract
date added to LUP
2014-06-05 00:03:53
date last changed
2017-01-01 04:02:19
@article{d68b9263-503f-4f75-8e67-047d5f36793d,
  abstract     = {Clinical observation suggested to us that aphasia recovers relatively better than other deficits early after intravenous recombinant tissue plasminogen activator (IV-rtPA) treatment in stroke patients with minor deficits, while the reverse seemed the case in those with severe deficits. Retrospective analysis of acute ischemic stroke patients with aphasia admitted within 3hours from symptom onset and treated with IV-rtPA was carried out. Stroke severity, aphasia and global neurological impairment were assessed at admission and 24hours after thrombolysis. Improvement of aphasia (gain of ⩾1 point on the National Institutes of Health Stroke Scale [NIHSS] aphasia score) and global neurological improvement (gain of ⩾4 points on the NIHSS) were compared in minor strokes (NIHSS ⩽7), moderate strokes (NIHSS 8-15), and major strokes (NIH ⩾16). Sixty-nine of 243 stroke patients suffered from aphasia. Improvement of aphasia occurred in 7/16 minor strokes, 11/25 moderate strokes, and 7/28 severe strokes. Improvement of ⩾4 points on the NIHSS occurred in 3/16 minor strokes, 17/25 moderate strokes and 15/28 severe strokes. There is a significant (X(2)=4.073, p&lt;0.05) dissociation of recovery of aphasia and that of other neurological deficits between minor versus severe strokes. This confirms the clinically suspected dissociation between a good early recovery from aphasia in minor strokes relative to recovery of other neurological deficits, as opposed to a better recovery from other neurological deficits than from aphasia in patients with severe strokes.},
  author       = {Kremer, Christine and Kappelin, Johan and Perren, Fabienne},
  issn         = {1532-2653},
  language     = {eng},
  number       = {10},
  pages        = {1828--1830},
  publisher    = {Elsevier},
  series       = {Journal of Clinical Neuroscience},
  title        = {Dissociation of severity of stroke and aphasia recovery early after intravenous recombinant tissue plasminogen activator thrombolysis.},
  url          = {http://dx.doi.org/10.1016/j.jocn.2014.01.010},
  volume       = {21},
  year         = {2014},
}