Thrombolysis in dementia patients with acute stroke: is it justified?

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• 作者：Maurizio Paciaroni ; Leonardo Pantoni
• 关键词：rt ; PA ; Cerebral hemorrhage ; Small vessel disease ; Dementia ; Amyloid angiopathy ; Outcome
• 刊名：Neurological Sciences
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：38
• 期：1
• 页码：27-31
• 全文大小：410KB
• 刊物类别：Medicine
• 刊物主题：Neurology; Neuroradiology; Neurosurgery; Psychiatry;
• 出版者：Springer Milan
• ISSN：1590-3478
• 卷排序：38

文摘

The administration of thrombolytic therapy in elderly patients with dementia and acute ischemic stroke may be controversial, because the reported risk of rt-PA associated intracerebral hemorrhage in these patients is higher compared with that of patients without dementia and because these patients are already disabled. Moreover, there are known risk factors for hemorrhagic transformation in patients with dementia: amyloid angiopathy, leukoaraiosis and the presence of microbleeds. In this review, we describe the impact of dementia on functional outcome following thrombolytic therapy for acute ischemic stroke and discuss some of the issues related to the use of this therapy in this specific patient’s population.