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128608

Effect of Tissue Plasminogen Activator on Treatment Outcome and Neuronal Degeneration in Acute Ischemic Stroke

Article

Last updated: 22 Jan 2023

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Tags

Internal Medicine

Abstract

Background: Acute ischemic stroke [AIS] is a leading worldwide neurological morbidity with significant disability. Recombinant tissue plasminogen activator [r-TPA] is approved for the treatment of AIS.Neuron-specific enolase [NSE] is a marker of brain damage in patients with traumatic brain injury, stroke, and hypoxic encephalopathy.
Aim of the work: The present study assessed the prognostic value of serum NSE in r-TPA treatment of patients with AIS.
Patients and methods: The present prospective study included 53 patients with AIS. They comprised 25 patients who didn't receive r-TPA and 28 patients who received r-TPA. The clinical severity of the stroke was assessed using National Institute of Health Stroke Scale [NIHSS]. A modified Rankin score was used to evaluate the degree of disability in the affected patients. Radiological imaging included echocardiography, brain computed tomography, and carotid and vertebrobasilar duplex. NSE was assessed at 24 h after r-TPA infusion.
Results: Patients subjected to r-TPA treatment had significantly lower NSE one day of stroke when compared with another group [23.7 ±14.3 versus 11.9 ± 8.9; p=0.001]. Also, patients with r-TPA treatment had a significantly higher frequency of favorable outcome at day 90 [67.8 % versus 44.0 %; p=0.001]. Interestingly, NSE levels one day after stroke were significantly lower in patients with favorable outcome [14.39 ±9.6 versus 19.83 ±14.9; p=0.048] and showed significant correlation with infarct size [r=0.63;p=0.001] and NIHSS after 24h [r=0.67;p=0.001].
Conclusion: r-TPA treatment resulted in a significant decrease in NSE levels. These levels were significantly correlated with infarct size, NIHSS at 24 hours, and MRS at 90 days.

DOI

10.21608/ijma.2020.47340.1196

Keywords

Acute ischemic stroke, Recombinant tissue plasminogen activator, Neuron-specific enolase

Authors

First Name

Muhammad

Last Name

Masoud

MiddleName

-

Affiliation

Lecturer of Neurologyو Faculty of Medicineو Beni-Suef University

Email

m_4neuro@yahoo.com

City

-

Orcid

-

First Name

Shimaa

Last Name

Abd Elkareem

MiddleName

-

Affiliation

Lecturer of Clinical Pathology Faculty of Medicine – Beni-Suef University

Email

m4neuro@yahoo.com

City

-

Orcid

-

First Name

Somia

Last Name

Sayed

MiddleName

-

Affiliation

Department of Neurology Faculty of Medicine – Beni-Suef University

Email

neuro4@yahoo.com

City

-

Orcid

-

First Name

Hatem

Last Name

Elmasry

MiddleName

-

Affiliation

Professor of Neurology Faculty of Medicine – Beni-Suef University

Email

neuro4m@yahoo.com

City

-

Orcid

-

Volume

3

Article Issue

1

Related Issue

21557

Issue Date

2021-01-01

Receive Date

2020-10-22

Publish Date

2021-01-01

Page Start

1,113

Page End

1,118

Print ISSN

2636-4174

Online ISSN

2682-3780

Article File

IJMA_Volume 3_Issue 1_Pages 1113-1118.pdf

PDF . 1.9MB

Link

https://ijma.journals.ekb.eg/article_128608.html

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https://ijma.journals.ekb.eg/service?article_code=128608

Order

29

Type

Original Article

Type Code

816

Publication Type

Journal

Publication Title

International Journal of Medical Arts

Publication Link

https://ijma.journals.ekb.eg/

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Details

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Article

Created At

22 Jan 2023