Acute stroke: Usefulness of early CT findings before thrombolytic therapy

Rüdiger Von Kummer, Kathryn L. Allen, Rolf Holle, Luigi Bozzao, Stefano Bastianello, Claude Manelfe, Erich Bluhmki, Peter Ringleb, Dieter H. Meier, Werner Hacke

Research output: Contribution to journalArticle

477 Citations (Scopus)

Abstract

PURPOSE: To determine whether the extent of subtle parenchymal hypoattenuation detected on computed tomographic (CT) scans obtained within 6 hours of ischemic stroke is a factor in predicting patients' response to thrombolytic treatment. MATERIALS AND METHODS: The baseline CT scans of 620 patients, who received either recombinant tissue plasminogen activator (rt- PA) or a placebo, in a double-blind, randomized multicenter trial were prospectively evaluated and assigned to one of three categories according to the extent of parenchymal hypoattenuation: none, 33% or less (small), or more than 33% (large) of the middle cerebral artery territory. The association between the extent of hypoattenuation on the baseline CT scans and the clinical outcome in the placebo-treated and the rt-PA-treated groups after 3 months was analyzed. RESULTS: In 215 patients with a small hypoattenuating area, treatment increased the chance of good outcome. In 336 patients with a normal CT scan and in 52 patients with a large hypoattenuating area, rt-PA had no beneficial effect but increased the risk for fatal brain hemorrhage. CONCLUSION: The response to rt-PA in patients with ischemic stroke can be predicted on the basis of initial CT findings of the extent of parenchymal hypoattenuation in the territory of the middle cerebral artery.

Original languageEnglish
Pages (from-to)327-333
Number of pages7
JournalRadiology
Volume205
Issue number2
Publication statusPublished - Nov 1997

Fingerprint

Thrombolytic Therapy
Stroke
Middle Cerebral Artery
Placebos
Intracranial Hemorrhages
Tissue Plasminogen Activator
Multicenter Studies
Therapeutics

Keywords

  • Brain, CT
  • Brain, edema
  • Brain, infarction
  • Brain, ischemia
  • Cerebral blood vessels, thrombosis
  • Thrombolysis

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Von Kummer, R., Allen, K. L., Holle, R., Bozzao, L., Bastianello, S., Manelfe, C., ... Hacke, W. (1997). Acute stroke: Usefulness of early CT findings before thrombolytic therapy. Radiology, 205(2), 327-333.

Acute stroke : Usefulness of early CT findings before thrombolytic therapy. / Von Kummer, Rüdiger; Allen, Kathryn L.; Holle, Rolf; Bozzao, Luigi; Bastianello, Stefano; Manelfe, Claude; Bluhmki, Erich; Ringleb, Peter; Meier, Dieter H.; Hacke, Werner.

In: Radiology, Vol. 205, No. 2, 11.1997, p. 327-333.

Research output: Contribution to journalArticle

Von Kummer, R, Allen, KL, Holle, R, Bozzao, L, Bastianello, S, Manelfe, C, Bluhmki, E, Ringleb, P, Meier, DH & Hacke, W 1997, 'Acute stroke: Usefulness of early CT findings before thrombolytic therapy', Radiology, vol. 205, no. 2, pp. 327-333.
Von Kummer R, Allen KL, Holle R, Bozzao L, Bastianello S, Manelfe C et al. Acute stroke: Usefulness of early CT findings before thrombolytic therapy. Radiology. 1997 Nov;205(2):327-333.
Von Kummer, Rüdiger ; Allen, Kathryn L. ; Holle, Rolf ; Bozzao, Luigi ; Bastianello, Stefano ; Manelfe, Claude ; Bluhmki, Erich ; Ringleb, Peter ; Meier, Dieter H. ; Hacke, Werner. / Acute stroke : Usefulness of early CT findings before thrombolytic therapy. In: Radiology. 1997 ; Vol. 205, No. 2. pp. 327-333.
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