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22. European Stroke Conference 6 Acute stroke: current treatment & new treatment concepts 9:20 - 9:30 Safety of thrombolysis in stroke mimics: results from a multicenter cohort study P.J. Nederkoorn1, S.M. Zinkstok2, S.T. Engelter3, H. Gensicke4, P.A. Ringleb5, V. Artto6, D. Leys7, H. Sarikaya8, C Odier9, J. Berrouschot10, M.R. Heldner11, A. Zini12, V. Padjen13, A. Pezzi-ni14 Academic Medical Center University of Amsterdam, Amsterdam, THE NETHER-LANDS1, Academic Medical Center University of Amsterdam, Amsterdam, THE NETHER-LANDS2, University Hospital Basel, Basel, SWITZERLAND3, University Hospital Basel, Basel, SWITZERLAND4, University Hospital Heidelberg, Heidelberg, GERMANY5, Helsinki University Central Hospital, Helsinki, FINLAND6, Lille University Hospital, Lille, FRANCE7, University Hospital Zurich, Zurich, SWITZERLAND8, Centre Hospitalier Universitaire Vaudo-is, Lausanne, SWITZERLAND9, Municipal Hospital Altenburg, Altenburg, GERMANY10, University Hospital Bern, Bern, SWITZERLAND11, Nuovo Ospedale Civile, AUSL Modena, Modena, ITALY12, Clincal Center, School of Medicine, University of Belgrade, Belgrade, SERBIA13, University Hospital of Bres-cia, Brescia, ITALY14 Background Intravenous thrombolysis (IVT) for acute ischemic stroke is beneficial within 4.5 hours of symptom onset, but the effect rapidly decreases over time necessitating quick diagnostic in-hos-pital work-up. Initial time strain occasionally results in treatment of patients with an alternate diagnosis (‘stroke mimics’). We investigated whether IVT is safe in these patients. Methods In this multicenter observational cohort study containing 5581 consecutive patients treated with IVT, we determined the frequency and the clinical characteristics of stroke mimics. For safety, we compared the symptomatic intracranial hemorrhage (SICH, ECASS-II definition) rate of stroke mimics with ischemic strokes. Variables distinguishing stroke mimics from strokes were identified using multivariable logistic regression analysis. Results One hundred stroke mimics were identified, resulting in a frequency of 1.8% (95% CI 1.5–2.2). The SICH rate in stroke mimics was 1.0% (95% CI 0.0–5.0) compared to 7.9% (95% CI 7.2– 8.7) in ischemic strokes. Decreasing age, female sex, absence of hypertension, absence of atrial fibrillation, history of previous stroke or TIA and lower NIHSS scores distinguished patients with a stroke mimic from patients with a stroke. Conclusions In experienced stroke centers, among patients treated with IVT only few had a final diagnosis other than stroke. Complication rate in these stroke mimics was low. 5 Acute stroke: current treatment & new treatment concepts 9:10 - 9:20 Predictive factors of dramatic recovery after IV thrombolysis in anterior circulation isch-emic stroke J.M. Rocha1, J.D. Pinho2, S.D. Varanda3, M. Ribeiro4, J. Rocha5, J.R. Fontes6, R. Maré7, C. Ferreira8 Hospital de Braga, Braga, PORTUGAL1,Hospital de Braga, Braga, PORTUGAL2, Hospital de Braga, Braga, PORTUGAL3, Hospital de Braga, Braga, PORTUGAL4, Hospital de Bra-ga, Braga, PORTUGAL5, Hospital de Braga, Braga, PORTUGAL6, Hospital de Braga, Braga, PORTUGAL7, Hospital de Braga, Braga, PORTUGAL8 BACKGROUND: Dramatic recovery (DR) after thrombolysis in ischemic stroke is predictive of favorable clinical outcome and is associated with complete arterial recanalization and time to recanalization. However, successful recanalization is not equivalent to DR. Our objective was to evaluate clinical and analytical predictors of DR after IV thrombolysis. METHODS: Prospectively registered data on IV thrombolysis from January 2007 to September 2012 was analyzed and 230 patients with anterior circulation stroke with NIHSS ≥10 were included. Improvement of ≥10 on NIHSS or NIHSS ≤3 24h after thrombolysis was defined as DR. We compared patients with and without DR concerning demographics, vascular risk factors, clini-cal presentation, ASPECTS, presence of hyperdense MCA sign (HMCA) on admission CT and 24h after thrombolysis, any intracranial hemorrhage on 24h-control CT and stroke etiology. RESULTS: DR occurred in 53 patients (23%). DR group had lower admission NIHSS (14 vs 17, p=0.038), less total anterior circulation infarcts (p=0.009), more partial anterior circulation infarcts (p=0.003) and lower blood glucose on admission (122.9 vs 142.5mg/dL, p=0.004). All patients with DR had ASPECTS ≥7, vs 89,3% without DR (p=0.013). Arterial recanalization, defined as HMCA disappearance on control CT, was more frequent in the DR group (68.4% vs 14.1%, p<0.001). Intracranial hemorrhage on 24h-control CT scan was less frequent in the DR group (p<0.001). Groups did not differ concerning stroke etiology. Multinomial logistic re-gression analysis showed that CT evidence of recanalization was independently associated with DR (OR=8.52, 95%CI=2.44-27.87, p=0.001). CONCLUSION: Frequency of DR in this study is similar to that reported in literature. DR is independently associated with CT evidence of middle cerebral artery recanalization and patients with less severe manifestations, lower blood glucose on admission and ASPECTS score ≥7 are those who benefit the most with IV throm-bolysis. 12 © 2013 S. Karger AG, Basel Scientific Programme


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