Skip to main content

Intravenous Tissue Plasminogen Activator in Acute Thromboembolic Stroke: A Placebo-Controlled, Double-Blind Trial

  • Conference paper
Thrombolytic Therapy in Acute Ischemic Stroke II

Abstract

Dramatic improvement of clinical symptoms and signs is not infrequent in patients with acute ischemic stroke. Such a syndrome has been called the “spectacular shrinking deficit,” and its mechanism is presumed to be the rapid migration of an embolus to the distal branches of a cerebral artery after initially lodging in the main trunk [6, 7]. Supporting evidence for the mechanism and the frequency of this phenomenon has recently been reported by Minematsu and coworkers [5]. The existence of such patients encouraged us to carry out a clinical trial of thrombolytic therapy in acute ischemic stroke prior to the appearance of ischemic findings on computed tomography (CT).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adams RJ, Meador KJ, Sethi KD, Grotta JC, Thompson DS (1987) Graded neurological scale for use in acute hemispheric stroke treatment protocols. Stroke 18:665–669

    Article  PubMed  CAS  Google Scholar 

  2. Brott TG, Haley EC, Levy DE, et al (1992) Urgent therapy for stroke. Part I. Pilot study of tissue plaminogen activator administered within 90 minutes. Stroke 23:632–640

    Article  PubMed  CAS  Google Scholar 

  3. Cerebral Embolism Task Force (1989) Cardiogenic brain embolism. Arch Neurol 46:727–743

    Article  Google Scholar 

  4. Hacke W, Zeumer H, Ferbert A, Bruckmann H, del Zoppo GJ (1988) Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 19:1216–1222

    Article  PubMed  CAS  Google Scholar 

  5. Minematsu K, Yamaguchi T, Omae T (1992) Spectacular shrinking deficit: Rapid recovery from a major hemispheric syndrome by migration of an embolus. Neurology 42:157–162

    PubMed  CAS  Google Scholar 

  6. Mohr JP, Barnett HJM (1986) Classification of ischemic strokes. In: Barnett HJM, Stein BM, Mohr JP, Yatsu FM (eds) Stroke: Pathophysiology, diagnosis and management, Volume 1. Churchill Livingstone, New York, p 281

    Google Scholar 

  7. Mohr JP, Gautier JC, Hier DB, Stein BM (1986) Middle cerebral artery. In: Barnett HJM, Stein BM, Mohr JP, Yatsu FM (eds) Stroke: Pathophysiology, diagnosis and management, Volume 1. Churchill Livingstone, New York, p 377

    Google Scholar 

  8. Mori E, Tabuchi M, Yoshida T, Yamadori A (1988) Intracarotid urokinase with thromboembolic occlusion of the middle cerebral artery. Stroke 19:802–812

    Article  PubMed  CAS  Google Scholar 

  9. Mori E, Yoneda Y, Tabuchi M, et al (1992) Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology 42:976–982

    PubMed  CAS  Google Scholar 

  10. von Kummer R, Hacke W (1992) Safety and efficacy of intravenous tissue plasminogen activator and heparin in acute middle cerebral artery. Stroke 23:646–652

    Article  Google Scholar 

  11. Yamaguchi T, Hayakawa T, Kikuchi H, Abe T (1991) Thrombolytic therapy in embolic and thrombotic cerebral infarction: A cooperative study. In: Hacke W, del Zoppo GJ, Hirschberg M (eds) Thrombolytic therapy in acute ischemic stroke. Springer-Verlag, Berlin Heidelberg New York, p 168

    Google Scholar 

  12. Yamaguchi T, Minematsu K, Choki J, Ikeda M (1984) Clinical and neuroradiological analysis of thrombotic and embolic cerebral infarction. Jpn Circ J 48:50–58

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Yamaguchi, T., Hayakawa, T., Kikuchi, H. (1993). Intravenous Tissue Plasminogen Activator in Acute Thromboembolic Stroke: A Placebo-Controlled, Double-Blind Trial. In: del Zoppo, G.J., Mori, E., Hacke, W. (eds) Thrombolytic Therapy in Acute Ischemic Stroke II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78061-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78061-5_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56442-3

  • Online ISBN: 978-3-642-78061-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics