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Scientific article
English

Dissociation of severity of stroke and aphasia recovery early after intravenous recombinant tissue plasminogen activator thrombolysis

Published inJournal of clinical neuroscience, vol. 21, no. 10, p. 1828-1830
Publication date2014
Abstract

Clinical observation suggested to us that aphasia recovers relatively better than other deficits early after intravenous recombinant tissue plasminogen activator (IV-rtPA) treatment in stroke patients with minor deficits, while the reverse seemed the case in those with severe deficits. Retrospective analysis of acute ischemic stroke patients with aphasia admitted within 3 hours from symptom onset and treated with IV-rtPA was carried out. Stroke severity, aphasia and global neurological impairment were assessed at admission and 24 hours after thrombolysis. Improvement of aphasia (gain of ⩾ 1 point on the National Institutes of Health Stroke Scale [NIHSS] aphasia score) and global neurological improvement (gain of ⩾ 4 points on the NIHSS) were compared in minor strokes (NIHSS ⩽ 7), moderate strokes (NIHSS 8-15), and major strokes (NIH ⩾ 16). Sixty-nine of 243 stroke patients suffered from aphasia. Improvement of aphasia occurred in 7/16 minor strokes, 11/25 moderate strokes, and 7/28 severe strokes. Improvement of ⩾ 4 points on the NIHSS occurred in 3/16 minor strokes, 17/25 moderate strokes and 15/28 severe strokes. There is a significant (X(2)=4.073, p<0.05) dissociation of recovery of aphasia and that of other neurological deficits between minor versus severe strokes. This confirms the clinically suspected dissociation between a good early recovery from aphasia in minor strokes relative to recovery of other neurological deficits, as opposed to a better recovery from other neurological deficits than from aphasia in patients with severe strokes.

Keywords
  • Administration, Intravenous
  • Aphasia/drug therapy/etiology
  • Brain Ischemia/complications/drug therapy
  • Female
  • Fibrinolytic Agents/therapeutic use
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Recombinant Proteins/therapeutic use
  • Recovery of Function/drug effects
  • Severity of Illness Index
  • Stroke/complications/drug therapy
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator/therapeutic use
Citation (ISO format)
KREMER, Christine, KAPPELIN, Johan, PERREN, Fabienne. Dissociation of severity of stroke and aphasia recovery early after intravenous recombinant tissue plasminogen activator thrombolysis. In: Journal of clinical neuroscience, 2014, vol. 21, n° 10, p. 1828–1830. doi: 10.1016/j.jocn.2014.01.010
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Article (Published version)
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Identifiers
ISSN of the journal0967-5868
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