[Thrombolytic therapy in cerebral infarction].

BACKGROUND

Intravenous thrombolysis has gained widespread acceptance during the last 10 years, and is the only specific treatment approved for cerebral infarction. Haukeland University hospital introduced thrombolysis in 1998. The aim of this paper is to summarize our experience with the first 100 patients who had stroke caused by middle cerebral artery (MCA) occlusion and were treated with thrombolysis.

MATERIALS AND METHODS

Patients receiving intravenous thrombolytic treatment between 1998 and 2005 were prospectively included into our database. We registered demographic data, risk factors, time aspects, short and long-term clinical results and complications.

RESULTS

Two hours after treatment, a definite clinical improvement was recorded in 30 % of patients, and after 24 hrs in 49 % of the patients. Symptomatic haemorrhages were seen in 2 % of the cases. Three patients underwent haemicraniectomy because of malignant cerebral oedema and danger of hernia. At three months follow-up, 55 % of the patients had a good outcome (independence), while 13 % were dead. Time from stroke onset to start of thrombolysis was reduced from 166 to 142 min during the study period.

INTERPRETATION

The results for the first 100 acute MCA stroke patients treated with thrombolysis in Haukeland University Hospital compare well with international data, both for clinical outcome and complications. Our results thereby support the notion that intravenous thrombolysis is effective and safe when applied as a routine treatment in a comprehensive stroke unit.