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J Stroke Cerebrovasc Dis. 2014 May-Jun;23(5):1089-93. doi: 10.1016/j.jstrokecerebrovasdis.2013.09.015. Epub 2013 Oct 14.

Thrombolytic therapy is an only determinant factor for stroke evolution in large anterior choroidal artery infarcts.

Author information

1
Stroke Center and Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
2
Stroke Center and Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Neurology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan. Electronic address: milikai@ntuh.gov.tw.
3
Department of Neurology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.

Abstract

BACKGROUND:

Large anterior choroidal artery (AChA) infarcts are frequently associated with stroke evolution. This study aimed to investigate the major determinants for stroke evolution in patients with large AChA infarcts.

METHODS:

We studied 118 consecutive adult patients with acute large AChA infarcts. The diagnosis was confirmed as abnormal hyperintensities in 3 or more rostracaudal magnetic resonance imaging slices (5 mm thickness) using diffusion-weighted imaging within typical AChA vascular regions. Stroke evolution was defined as neurologic deterioration with an increase in National Institutes of Health Stroke Scale (NIHSS) score by at least 4 or an increase of NIHSS score in motor function by at least 2 in 7 days after stroke onset.

RESULTS:

Forty-seven (39.8%) patients developed stroke evolution. Thrombolytic therapy was inversely associated with the occurrence of stroke evolution (P = .004). Using multivariate analysis, thrombolytic therapy was the only protective determinant for stroke evolution (adjusted odds ratio, .08; 95% confidence interval, .01 to .67). Patients with large AChA infarcts receiving thrombolytic therapy had less unfavorable long-term functional outcome than those not receiving thrombolytic therapy (adjusted odds ratio, .11; 95% confidence interval, .02-.75).

CONCLUSIONS:

Thrombolytic therapy is an only determinant factor for stroke evolution in large AChA infarcts, which reduced the risk of stroke evolution and improved functional outcome.

KEYWORDS:

Anterior choroidal artery; cerebral infarct; outcome; stroke evolution; thrombolytic therapy; treatment

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