Friday, September 09, 2016

TPA administration in patients with stroke mimic

In patients with stroke mimic one would expect a lower incidence of head bleed as compared to patients with actual stroke because their brain tissues are not as friable. Reported experience confirms that this is the case as pointed out in this review. The incidence of head bleed in stroke mimic is in fact much lower. Comforting as that may seem the perspective offered by the article warrants emphasis:

In summary, the rate of sICH in patients with stroke mimic who receive intravenous thrombolytics is low in published data, although this estimate may be lower than that observed in clinical practice.9 Patients with stroke mimics generally were younger, were women, and had lower NIHSS scores. Fully functional outcome was 3-fold more likely for patients with stroke mimic compared with that for AIS patients. However, the risk of causing harm to even 1 patient given intravenous thrombolytics in the setting of a stroke mimic is concerning,

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