A Study of Clinical Profile of Patients Undergoing Stroke Thrombolysis in a Tertiary Care Hospital

Yamini, M (2019) A Study of Clinical Profile of Patients Undergoing Stroke Thrombolysis in a Tertiary Care Hospital. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION Institution of intra-venous thrombolysis as treatment modality for acute ischemic stroke has revolutionalised the field of Neuromedicine in the past few years. The concept of thrombolysis and various endovascular interventions for acute stroke has opened the doors of the field of Interventional Neurology. The better availability of Neuro-imaging services has enhanced the decision making capacity for using acute thrombolysis. Like myocardial infarction, acute ischemic stroke is equivalent to “Brain Attack”. It should be treated as acute emergency and top priority to be given during triage. Preventing the rapid loss of neurons due to ischemic insult, and preserving the ischemic penumbra from permanent damage is the corner stone of the thrombolytic therapy in AIS. Effective treatment with proper response is very important in prevention of complications and improving the quality of life of the patient. OBJECTIVE: The aim of present study is to assess the clinical outcome and improvement in quality of life of patients undergoing intravenous thrombolysis for acute ischemic stroke in tertiary care center. DESIGN: Prospective descriptive study. Setting: Department of Internal Medicine , Government Stanley Medical College from April 2018 –August 2018 METHODS: The detailed history of the patients were recorded and patients underwent a detailed clinical examination. Patients were assessed according to NIHSS score at the time of admission. Early routine investigations including imaging with non –contrast CT scan is done. Patients were thrombolysed using intra venous Alteplase 10% of dose as bolus and 90% over hour. Reassessment of patient was done after 24 hours to look for primary outcome i.e decrease in NIHSS score by ≥4 indicating good prognosis in that patient. Repeat CT is done to rule out any bleeding complications. Patients are discharged and routinely followed up. At the end of 3 months patients are assessed by using Modified Rankin Score. Results: Out of 30 patients studied, the maen NIHSSS score at time of admission is 12.60, after 24 hours was 7.83, primary outcome was present in 60 % (reduction of NIHSS by 4%), secondary outcome at the end of 3 months was 76% (m RS score 0-2). CONCLUSION: After thrombolysis, for acute ischemic stroke substantial reduction in NIHSS score & better physical quality of life was observed after 3 months.

Item Type: Thesis (Masters)
Uncontrolled Keywords: acute ischemic stroke, NIHSS score, modified Rankin score.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 27 Aug 2019 03:51
Last Modified: 31 Aug 2019 16:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/11260

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