Literature Review and Case Report of Intravenous Thrombolysis in Acute Cerebral Infarction Attributed to Cervical Arterial Dissection

BACKGROUND: Acute cerebral infarction (ACI) is a common cerebrovascular disease in clinical practice. OBJECTIVE: The present study aims to investigate the efficacy and safety of alteplase and urokinase in treating ACI. METHODS: A total of 96 patients with ACI, who were treated with alteplase and urokinase, were selected as the main subjects. Among these patients, 45 patients with ultra-early acute cerebral infarction, who received intravenous thrombolysis with RT-PA (alteplase), were included in the treatment group, while 51 patients with acute cerebral infarction, who were treated with urokinase in the same time period, were included in the control group. RESULTS: The National Institute of Health Stroke Scale (NIHSS) scores were significantly lower in the treatment group and control group (P< 0.05) at two hours, seven days and 14 days after thrombolysis, when compared to those before thrombolysis. The bleeding rate was significantly lower in the control group, when compared to the treatment group (P< 0.05). CONCLUSION: The intravenous thrombolysis with urokinase or alteplase in the ultra-early stage of acute cerebral infarction can reduce the neurological injury symptoms and effectively improve the prognosis of patients with stroke. Urokinase is lower in risk of bleeding, but better in safety, when compared to alteplase.

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Comparative study of intravenous thrombolysis with rt-PA and urokinase for patients with acute cerebral infarction

Journal of International Medical Research ◽

10.1177/0300060519895352 ◽

2020 ◽

Vol 48 (5) ◽

pp. 030006051989535

Author(s):

Fan Sun ◽

Heng Liu ◽

Hui-xiao Fu ◽

Shuo Zhang ◽

Xu-dong Qian ◽

...

Keyword(s):

Cerebral Infarction ◽

Time Window ◽

Intravenous Thrombolysis ◽

Cerebral Haemorrhage ◽

Recombinant Tissue Plasminogen Activator ◽

Serum Levels ◽

Acute Cerebral Infarction ◽

Bleeding Complications ◽

Therapeutic Effects ◽

Clinical Trial Evidence

Objective Cerebral infarction has a poor prognosis and causes a serious burden on families and society. Recombinant tissue plasminogen activator (rt-PA) and urokinase (UK) are commonly used thrombolytic agents in the clinic. However, direct and powerful clinical trial evidence to determine the therapeutic effect of rt-PA and UK on intravenous thrombolysis is lacking. Methods In this study, 180 patients with acute cerebral infarction were treated with rt-PA or UK. The National Institutes of Health Stroke Scale (NIHSS) scores, Barthel index, bleeding complications, and biomarkers were evaluated. Results No significant differences in NIHSS or Barthel scores were found between the groups. However, UK increased the risk of intracranial haemorrhage compared with rt-PA. rt-PA had increased activity in reducing serum levels of MMP-9 than UK. Conclusion Intravenous thrombolysis with rt-PA and UK in the time window of acute cerebral infarction can achieve similar therapeutic effects, but rt-PA can further reduce the risk of cerebral haemorrhage and is relatively safer than UK.

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Desulfovibrio desulfuricans bacteremia in a patient hospitalized with acute cerebral infarction: Case report and review

Journal of Infection and Chemotherapy ◽

10.1016/j.jiac.2013.10.009 ◽

2014 ◽

Vol 20 (4) ◽

pp. 274-277 ◽

Cited By ~ 12

Author(s):

Shigehiro Hagiwara ◽

Atsushi Yoshida ◽

Yuki Omata ◽

Yumiko Tsukada ◽

Hirohumi Takahashi ◽

...

Keyword(s):

Case Report ◽

Cerebral Infarction ◽

Desulfovibrio Desulfuricans ◽

Acute Cerebral Infarction

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Persistent Working Memory Impairment Associated with Cerebral Infarction in the Anterior Cingulate Cortex: A Case Report and a Literature Review

Internal Medicine ◽

10.2169/internalmedicine.6927-20 ◽

2021 ◽

Author(s):

Yuya Kobayashi ◽

Teruya Morizumi ◽

Kiyoshiro Nagamatsu ◽

Yusaku Shimizu ◽

Keisuke Kamiya ◽

...

Keyword(s):

Working Memory ◽

Case Report ◽

Literature Review ◽

Cerebral Infarction ◽

Anterior Cingulate Cortex ◽

Memory Impairment ◽

Cingulate Cortex ◽

Anterior Cingulate

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Successful Intravenous Thrombolysis in Ischemic Stroke Caused by Tuberculous Meningitis: A Case Report

Frontiers in Neurology ◽

10.3389/fneur.2021.676684 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xinke Peng ◽

Xiaomei Wu ◽

Lingling Lv ◽

Qile Xiao ◽

Yajing Zhan ◽

...

Keyword(s):

Ischemic Stroke ◽

Case Report ◽

Cerebral Infarction ◽

Acute Stroke ◽

Tuberculous Meningitis ◽

Acute Treatment ◽

Clinical Manifestations ◽

Intravenous Thrombolysis ◽

Treatment Method ◽

Common Complication

Tuberculous meningitis (TBM) has a variety of clinical manifestations and complications, and ischemic stroke is a common complication of TBM. However, there is no established prevention or treatment for stroke associated with TBM, and the safety and efficiency of thrombolysis in acute stroke caused by TBM remain unknown. Herein, we present a case of successful intravenous thrombolysis in ischemic stroke caused by TBM. A 50-year-old male patient with cerebral infarction had substantially improved neurological function after intravenous thrombolysis, and he was subsequently found to have TBM. Our findings suggest that intravenous thrombolysis might be an effective acute treatment method for infectious stroke.

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