Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology

Yaka, Erdem; ÖZTÜRK, Vesile; KUTLUK, Kürşat; MEN, Süleyman; POYRAZ, TURAN; UGUREL, Burcu

Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology

Vesile ÖZTÜRK, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İzmir, Türkiye)

Erdem YAKA, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İzmir, Türkiye)

Burcu UGUREL, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İzmir, Türkiye)

Turan POYRAZ, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İzmir, Türkiye)

Süleyman MEN, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, İzmir, Türkiye)

Kürşat KUTLUK (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İzmir, Türkiye)

Journal of Neurological Sciences (Turkish)

3 0

Yıl: 2008 Cilt: 25 Sayı: 2 Sayfa Aralığı: 75 - 83 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology

Öz:

Akut inme (Aİ), dünyada ölüme ve sakatlığa yol açan hastalıklar içinde en başta gelenlerindendir. Kalp hastalıklarından sonra dünyada ölüme neden olan hastalıklar arasında ikinci sırada yer almaktadır. Tüm inmelerin %80'ini iskemik inmeler oluşturur. Son yıllarda akut iskemik inme tedavisinde trombolitik tedavinin uygulanmaya başlamasıyla inmenin tedavi edilemez bir durum olduğu görüşü yıkılmıştır. Bugün için, iskemik inmede beyin kan akımını tekrar sağlamak, iskemik hasarı azaltmak ve nörolojik dizabiliteyi sınırlamak için yapılabilecek en önemli tedavi girişimi akut dönemde uygulanan sistemik trombolitik tedavidir. Tedavi penceresinin oldukça dar olması, ciddi komplikasyonların ortaya çıkabilmesi ve donanımlı merkezlere gereksinim duyulması bu tedavi şansına sahip hasta sayısını sınırlamaktadır. Bu bildiride, 19.09.2006-30.01.2007 tarihleri arasında merkezimizde intravenöz (IV) rekombinan doku plazminojen aktivatörü (rt-PA) verilen 8 kadın, 13 erkek toplam 21 akut iskemik inme olgusu sunulmaktadır. Olguların nörolojik durumları tedavi verilmeden hemen önce, yirmi dördüncü saatte, birinci hafta ve üçüncü ayda yapılan “The National Institutes of Health Stroke Scale” (NIHSS) ile değerlendirilmiştir. Olguların yaklaşık üçte ikisinde ilk saatler ve ilk gün içinde belirgin klinik düzelme izlenmiş, bu düzelmenin 1. ve 3.ayda da devam ettiği gözlenmiştir. Sadece bir olguda tedaviye bağlı olduğu düşünülen semptomatik intrakranyal kanama gelişmiştir. Bir olgu kanama olmaksızın erken dönemde inmeye bağlı ödem artışı nedeniyle, bir olgu subakut, bir olgu da kronik dönemde nörolojik nedenler dışında sistemik nedenlerle kaybedilmiştir. Az sayıda olguyu içerse de bu sonuçlarla, iyi seçilmiş hastalarda IV rt-PA tedavisinin etkin ve güvenilir olduğu doğrulanmıştır.

Anahtar Kelime:

Konular: Nörolojik Bilimler

Akut iskemik inmede trombolitik tedavi:Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi Nöroloji Anabilim Dalı deneyimi

Öz:

Acute stroke is the second leading cause of death after heart diseases in the world. Acute ischemic stroke (AIS) accounts for 80% of all strokes. The idea that AIS is an incurable disease has been abolished during the recent years because of thrombolytic treatment. To date, the only proven therapy in acute ischemic stroke to prevent infarction and minimize the degree of permanent brain injury is thrombolytic treatment. But it has some limitations; it has narrow theuropatic index and high risk of serious complications and also well-established stroke centers are needed for this therapy. We present 21 patients with acute ischemic stroke (13 male, 8 female) who were treated with intravenous recombinant tissue plasminogen activator (IV rt-PA) in our department between 19.09.2006 – 30.01.2008. The neurological statuses of the patients were assessed by “The National Institutes of Health Stroke Scale” (NIHSS) before thrombolysis application, at 24 hour, at 1 week and at 3 months. At the first day of the therapy, 75% of patients had excellent global outcomes (minimal or no deficit). The neurological examinations of IV rt-PA patients at 1 month and at 3 months were also excellent. Symptomatic intracranial bleeding was occured in one patient as a result of IV rt-PA threapy. Four patients were died, one patient died because of brain edema without hemorrhage, one patient died because of brain hemorrhage, the others died because of systemic reasons. Despite low number of patients, our experience contributed important information that IV rt-PA treatment is effective and reliable in well-selected patients. How to cite this article: V. ÖZTÜRK, E. YAKA, B. UĞUREL, T. POYRAZ, S. MEN, K. KUTLUK: Intravenous Thrombolysis in Acute Ischemic Stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. J Neurol Sci [Turk] 2008;25:075-083How to cite this URL & PDF: V. ÖZTÜRK, E. YAKA, B. UĞUREL, T. POYRAZ, S. MEN, K. KUTLUK: Intravenous Thrombolysis in Acute Ischemic Stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. J Neurol Sci [Turk] 2008 [cited 2008 December 18];25:075-083. Available from: http://jns.dergisi.org/text.php3?id=212 PDF: http://jns.dergisi.org/pdf/pdf_JNS_212.pdfE-mail of the corresponding author: erdem.yaka@deu.edu.tr

Anahtar Kelime:

Konular: Nörolojik Bilimler

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÖZTÜRK V, Yaka E, UGUREL B, POYRAZ T, MEN S, KUTLUK K (2008). Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. , 75 - 83.
Chicago	ÖZTÜRK Vesile,Yaka Erdem,UGUREL Burcu,POYRAZ TURAN,MEN Süleyman,KUTLUK Kürşat Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. (2008): 75 - 83.
MLA	ÖZTÜRK Vesile,Yaka Erdem,UGUREL Burcu,POYRAZ TURAN,MEN Süleyman,KUTLUK Kürşat Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. , 2008, ss.75 - 83.
AMA	ÖZTÜRK V,Yaka E,UGUREL B,POYRAZ T,MEN S,KUTLUK K Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. . 2008; 75 - 83.
Vancouver	ÖZTÜRK V,Yaka E,UGUREL B,POYRAZ T,MEN S,KUTLUK K Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. . 2008; 75 - 83.
IEEE	ÖZTÜRK V,Yaka E,UGUREL B,POYRAZ T,MEN S,KUTLUK K "Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology." , ss.75 - 83, 2008.
ISNAD	ÖZTÜRK, Vesile vd. "Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology". (2008), 75-83.

APA	ÖZTÜRK V, Yaka E, UGUREL B, POYRAZ T, MEN S, KUTLUK K (2008). Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. Journal of Neurological Sciences (Turkish), 25(2), 75 - 83.
Chicago	ÖZTÜRK Vesile,Yaka Erdem,UGUREL Burcu,POYRAZ TURAN,MEN Süleyman,KUTLUK Kürşat Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. Journal of Neurological Sciences (Turkish) 25, no.2 (2008): 75 - 83.
MLA	ÖZTÜRK Vesile,Yaka Erdem,UGUREL Burcu,POYRAZ TURAN,MEN Süleyman,KUTLUK Kürşat Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. Journal of Neurological Sciences (Turkish), vol.25, no.2, 2008, ss.75 - 83.
AMA	ÖZTÜRK V,Yaka E,UGUREL B,POYRAZ T,MEN S,KUTLUK K Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. Journal of Neurological Sciences (Turkish). 2008; 25(2): 75 - 83.
Vancouver	ÖZTÜRK V,Yaka E,UGUREL B,POYRAZ T,MEN S,KUTLUK K Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology. Journal of Neurological Sciences (Turkish). 2008; 25(2): 75 - 83.
IEEE	ÖZTÜRK V,Yaka E,UGUREL B,POYRAZ T,MEN S,KUTLUK K "Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology." Journal of Neurological Sciences (Turkish), 25, ss.75 - 83, 2008.
ISNAD	ÖZTÜRK, Vesile vd. "Intravenous thrombolysis in acute ischemic stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology". Journal of Neurological Sciences (Turkish) 25/2 (2008), 75-83.