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dc.contributor.authorBaird, A Een
dc.contributor.authorDonnan, Geoffrey Aen
dc.contributor.authorAustin, M Cen
dc.contributor.authorFitt, Gregory Jen
dc.contributor.authorDavis, S Men
dc.contributor.authorMcKay, W Jen
dc.identifier.citationStroke; A Journal of Cerebral Circulation; 25(1): 79-85en
dc.description.abstractWe used 99mTc-hexamethylpropyleneamine oxime single-photon emission computed tomography (SPECT) to study cerebral perfusion in patients treated with streptokinase for acute ischemic stroke in an open and prospective study. Our primary aims were (1) to compare the extent of reperfusion between patients who had received thrombolytic therapy and a control group studied during the same period who were ineligible to receive such therapy and (2) to determine if, among all patients, reperfusion led to improved outcome.Fifty-seven patients (22 treated with streptokinase) had two SPECT studies performed, the first before streptokinase administration and the second 24 hours later.On the first SPECT study hyperfusion was present in the middle cerebral artery or anterior cerebral artery territories in 40 patients (17 treated with streptokinase). Patients in the treatment and control groups with initial hypoperfusion on SPECT were well matched for the volume of the perfusion defect and the severity of neurological deficit. A greater number of patients who received streptokinase developed at least partial reperfusion (streptokinase, 65%; control, 52%) on the second study but not significantly so (P = .43). Similarly, the proportion of each hypoperfused region that reperfused (P = .74) and the reduction in the size of the perfusion defect (P = .06) were higher in the streptokinase group but did not reach statistical significance. When all patients were considered, those who did not reperfuse had higher mortality rates (P = .008), less neurological improvement (P = .016), and more functional disability (P < .001) than patients who had reperfusion or normal perfusion initially.These findings suggest that at least some reperfusion during the first 48 hours of ischemic stroke is a common natural occurrence and is of prognostic significance. The observed trend toward better reperfusion indexes among patients treated with streptokinase is encouraging, but larger controlled trials are required to answer this definitively.en
dc.subject.otherBrain Ischemia.physiopathology.radionuclide imaging.therapyen
dc.subject.otherCerebral Angiographyen
dc.subject.otherCerebrovascular Disorders.physiopathology.radionuclide imaging.therapyen
dc.subject.otherNervous System.physiopathologyen
dc.subject.otherOrganotechnetium Compounds.diagnostic useen
dc.subject.otherOximes.diagnostic useen
dc.subject.otherPilot Projectsen
dc.subject.otherStreptokinase.therapeutic useen
dc.subject.otherSubtraction Techniqueen
dc.subject.otherSurvival Analysisen
dc.subject.otherTechnetium Tc 99m Exametazimeen
dc.subject.otherThrombolytic Therapyen
dc.subject.otherTomography, Emission-Computed, Single-Photonen
dc.subject.otherTreatment Outcomeen
dc.titleReperfusion after thrombolytic therapy in ischemic stroke measured by single-photon emission computed tomography.en
dc.typeJournal Articleen
dc.identifier.affiliationDepartment of Neurology, Austin Hospital, Victoria, Australiaen
dc.type.austinJournal Articleen
item.fulltextNo Fulltext-
item.openairetypeJournal Article- Florey Institute of Neuroscience and Mental Health-
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