PT -期刊文章盟-迈克尔·麦克马纳斯盟合作伙伴Sanossian盟Latisha阿里AU -西德尼·斯达克曼盟Neal Rao AU -杰森何曼盟Doojin金盟-保罗胡蜂属非盟-曼努埃尔·布兰科盟马特奥Calderon-Arnulphi盟Alireza Noorian盟关颖珊Ng AU -康拉德梁盟苏尼尔Sheth AU -法比Scalzo盟Jeffrey节省盟-大卫Liebeskind TI -解释解释:急性缺血性中风神经功能恶化(P6.244) DP - 2015年4月06 TA -神经病学PG - P6.244 VI - 84 IP - 14补充4099 - //www.ez-admanager.com/content/84/14_Supplement/P6.244.short 4100 - //www.ez-admanager.com/content/84/14_Supplement/P6.244.full所以Neurology2015 4月06;首页84 AB -目的:解释早期神经功能恶化。背景:不明原因早期神经功能恶化(ENDunexplained)被认为是发生在7 (percnt)的早期神经功能恶化病例IV-rtPA(结束)在24小时内。我们寻求解释通过回顾性图表和成像检查辨别诊断测试的角色在这个场景中。设计/方法:我们回顾了连续患者的临床和mri诊断急性缺血性中风接收IV-rTPA≤4.5小时从症状出现。最终被定义为增加署蠅4在24小时内。系统图审查确定的因素可以解释。ENDunexplained被定义为结束没有证据表明通过串行成像和没有相应诊断,可以解释恶化。结束,non-END患者相比,预处理独立变量:血糖,署,收缩压,TPA 3人力资源vs 4.5人力资源窗口,醉酒驾车体积和大型动脉阻塞的存在与否。结束和后处理变量:non-END患者相比存在与否的恶性水肿(我)或实质出血症状。 RESULTS: Among 127 patients, END was present in 19 patients (15[percnt]). Extension of ischemic infarction within an occluded vascular territory was the most common etiology followed by ME or ICH. ENDunexplained was not identified within the END group. Cases of END not confirmed by radiographic evaluation included: concomitant seizure activity, respiratory failure in context of sepsis, rapidly progressive heart failure and rapid deterioration in patients with known acute ICA or MCA occlusions without reperfusion. Significant associations were found between END and pretreatment DWI volume (p<0.001), post-treatment type-2 ICH (p<0.001) and malignant edema (p<0.001). CONCLUSIONS: Explaining ENDunexplained is contingent upon appropriate use of diagnostic modalities such as MRI, EEG and other rigorous diagnostic testing in the ICU and subacute epoch. Study Supported by:Neurovascular Imaging Research Core; UCLA Stroke CenterDisclosure: Dr. mcmanus has nothing to disclose. Dr. Sanossian has received personal compensation for activities with Boehringer Ingelheim Pharmaceuticals, Inc. as a speakers bureau participant. Dr. Ali has nothing to disclose. Dr. Starkman has received research support from the National Institutes of Health, Lundbeck Research USA, Inc., Mitsubishi Tanabe Pharma, and Neurobiological Technologies, Inc. Dr. Rao has nothing to disclose. Dr. Hinman has nothing to disclose. Dr. Kim has received personal compensation for activities with Boehringer Ingelheim as a speakers bureau member. Dr. Vespa has received personal compensation for activities with The Medicines Company, Edge Therapeutics, In Touch Pharmaceuticals, General Electric, and C3O Telemedicine as a speaker and/or consultant. Dr. Buitrago Blanco has nothing to disclose. Dr. Calderon-Arnulphi has nothing to disclose. Dr. Noorian has nothing to disclose. Dr. Ng has nothing to disclose. Dr. Liang has nothing to disclose. Dr. Sheth has nothing to disclose. Dr. Scalzo has nothing to disclose. Dr. Saver has received personal compensation for activities with the University of California, BrainsGate, CoAxia, eV3, Talecris Biotherapeutics Inc., and PhotoThera, Inc. Dr. Liebeskind has received personal compensation for activities with Stryker and Covidien as a consultant.Thursday, April 23 2015, 7:30 am-12:00 pm