Neurology Medical News about Ischemic Attack, Transient

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Transient Ischemic Attack after Tissue Plasminogen Activator: Aborted Stroke or Unnecessary Stroke Therapy
Cerebrovascular Diseases, 11/10/09

Uchino K et al. – Over 10% of patients who receive tPA for cerebral ischemia do not develop ischemic injury. tPA use for a nonischemic process is infrequent but is associated with community hospital use.

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Ken Uchino, 11/11/09

Over 10% of patients who receive intravenous tPA thrombolysis for presumed cerebral ischemia do no develop ischemic injury clinically or on brain imaging. Most of such excellent outcome is appear to be due to true transient ischemic event due to thrombolysis and "averting a stroke." As expected, such patients had milder stroke symptoms and lower glucose. Only a small portion, 3.5% of overall thrombolysis, are treatments that were likely not brain ischemia. Such stroke mimics are infrequent but were more common in community hospitals. As with any disease in emergent settings, there is an inherent diagnostic uncertainty. Whether the rate of stroke mimics is acceptable is a matter of opinion.

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