Open AccessA Retrospective Study on Intracerebral Haemorrhage Reduction by Mri versus Ct in Intravenous Thrombolysis for Acute Ischaemic Stroke
Author(s) -
Yun YH,
Chung JY,
Kang MJ,
Huh JT,
Park KW,
Cha JK
Publication year - 2010
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490791001700102
Subject(s) - medicine , thrombolysis , acute stroke , stroke (engine) , ischaemic stroke , radiology , magnetic resonance imaging , intracranial haemorrhage , tissue plasminogen activator , surgery , ischemia , neurosurgery , mechanical engineering , myocardial infarction , engineering
Multimodal MRI may be an effective tool for selecting suitable acute ischaemic stroke patients for thrombolysis, reducing the risk of haemorrhage. In this study, we demonstrated the usefulness of our central alerting system to reduce door‐to‐needle time for thrombolysis following MRI. This system allowed timely intervention and reduced the rate of symptomatic haemorrhage. Methods We reviewed the records of 73 patients with hyperacute ischaemic stroke who received intravenous (IV) tissue plasminogen activator (t‐PA) between January 2006 and December 2007 following the adoption of a central stroke alerting system in our hospital. Results Of the 73 patients who received IV t‐PA, 44 were based on CT and 29 on MRI findings. The door‐to‐needle time was 10 minutes longer for the MRI group (49.9±23.2 min) compared to the CT group (39.6±19.7 min) but it was still within the recommended 60 minutes time frame. On the other hand, the rate of symptomatic haemorrhage was lower, though insignificantly, in the MRI group (0%) compared to the CT group (13.6%) (p=0.08). Conclusions In this study, we demonstrated that the combination of diagnostic MRI and a central alerting system might reduce the rate of symptomatic haemorrhage without compromising the door‐to‐needle time.