Journal article
Use of Emergency Department Transcranial Doppler Assessment of Reperfusion After Intravenous tPA for Ischemic Stroke
The Journal of emergency medicine, v 42(1)
2012
PMID: 19111426
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Thrombolysis with intravenous recombinant tissue plasminogen activator (IV-tPA) has been associated with significant improvements in clinical outcomes when initiated within 3 h of symptom onset. Although adjunctive therapies for acute stroke have been developed, challenges remain in identifying appropriate patients and therapeutic end-point measurements. Objective: To describe the use of transcranial Doppler (TCD) monitoring in the Emergency Department (ED) to guide the decision for advanced reperfusion strategies after failure of IV-tPA. Case Report: A 75-year-old man presented to the ED within 50 min after the acute onset of right-sided hemiparesis and aphasia. After administration of IV-tPA, there was no immediate improvement in neurological symptoms. TCD performed in the ED demonstrated persistent left middle cerebral artery (MCA) occlusion. Based on this information, the patient received intra-arterial tPA followed by mechanical thrombectomy of the MCA occlusion, resulting in clinical improvement of the patient's right hemiparesis and aphasia. Conclusion: TCD is a feasible assessment tool for use in the ED to aid in diagnosis and to guide treatment decisions in patients with acute ischemic stroke, including those not responding to IV-tPA therapy.
Metrics
Details
- Title
- Use of Emergency Department Transcranial Doppler Assessment of Reperfusion After Intravenous tPA for Ischemic Stroke
- Creators
- Samantha Phillips - Duke UniversityLeanne Stanley - Duke UniversityHeather Nicoletto - Duke Medical CenterMarilyn Burkman - Duke Medical CenterDaniel T. Laskowitz - Duke Medical CenterCharles B. Cairns - University of North Carolina at Chapel Hill
- Publication Details
- The Journal of emergency medicine, v 42(1)
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000300142400007
- Scopus ID
- 2-s2.0-84856097379
- Other Identifier
- 991021448177304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Emergency Medicine