Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylul University Hospital, Medical Faculty, Department of Neurology

Acute stroke is the second leading cause of death after heart diseases in the world. Acute ischemic stroke (AIS) accounts for 80% of all strokes. The idea that AIS is an incurable disease has been abolished during the recent years because of thrombolytic treatment. To date, the only proven therapy in acute ischemic stroke to prevent infarction and minimize the degree of permanent brain injury is thrombolytic treatment. But it has some limitations; it has narrow theuropatic index and high risk of serious complications and also well-established stroke centers are needed for this therapy. We present 21 patients with acute ischemic stroke (13 male, 8 female) who were treated with intravenous recombinant tissue plasminogen activator (IV rt-PA) in our department between 19.09.2006 - 30.01.2008. The neurological statuses of the patients were assessed by "The National Institutes of Health Stroke Scale" (NIHSS) before thrombolysis application, at 24 hour, at 1 week and at 3 months. At the first day of the therapy, 75% of patients had excellent global outcomes ( minimal or no deficit). The neurological examinations of IV rt-PA patients at 1 month and at 3 months were also excellent. Symptomatic intracranial bleeding was occured in one patient as a result of IV rt-PA threapy. Four patients were died, one patient died because of brain edema without hemorrhage, one patient died because of brain hemorrhage, the others died because of systemic reasons. Despite low number of patients, our experience contributed important information that IV rt-PA treatment is effective and reliable in well-selected patients.