Presentations Of Acute Stroke Treated With Thrombolysis: A Clinical Profile

Introduction: Cerebrovascular accident is a leading cause of disability adjusted life years. With the advent of the therapeutic procedure of thrombolytic therapy, hope for the alleviation of the significant morbidity faced by these patients was seen. Along with the therapeutic procedure came the contradictory question of whether the benefits of truly outweighed the risks associated with the procedure.Aims & Objectives: To (1) create a profile of patients who have undergone Intra-venous Thrombolysis (IVT), Intra-arterial Thrombolysis (IAT) or IVT-IAT bridge therapy in a tertiary care hospital, (2) to compare the procedures and (3) to correlate their outcomes with a number of associated factors.Materials & Medthods: Design: Cross-sectional, Record Based Study-Retrolective Data Collection. Setting: Tertiary Care Centre in Mangalore, Karnataka, India. Participants: All cases of acute stroke, treated with IAT or IVT or IAT-IVT bridge therapy, as defined by the inclusion and exclusion criteria for undergoing thrombolysis in stroke patients. Main Outcome Measures: Permission was obtained from the Institutional Ethics Committee of Kasturba Medical College, Mangalore (Manipal University) to carry out the research. Approval was obtained from the Medical Superintendent to access hospital records. Data was collected in a semi-structured proforma. The data was collated and analysis was carried out using convenience sampling.Results: 25 non-randomized cases were studied. The mean ages were: men-58 years and women-57 years. Most patients were brought in between 0-3 hours. The commonest territory of infarction was the left MCA territory, and the commonest presenting symptom was right hemiparesis. IVT was more commonly used but IAT showed better outcomes. Hypertension was the most common associated risk factor (64.00%), and IAT showed a better outcome in hypertensives. MRS 6 was seen 100.00% in bridging therapy, 26.67% in IVT and 0.00% in IAT.Conclusions: IAT generally presented with a better outcome. Aphasia was related to a better outcome and facial palsy, to a poorer outcome.