Initial Glasgow Coma Scale score predicts outcome following thrombolysis for posterior circulation stroke

Jack Tsao, J. Claude Hemphill, S. Claiborne Johnston, Wade S. Smith, David C. Bonovich

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: Randomized trials of thrombolytic stroke treatment have either excluded patients with posterior circulation ischemia or used inclusion criteria making enrollment of these patients less likely. Consequently, there is less published information on thrombolytic therapy for posterior circulation stroke. Objective: To determine effective thrombolytic treatment times for posterior circulation stroke and factors that might help predict clinical outcome. Design: We describe our experience treating 21 consecutive patients with either intravenous or intra-arterial thrombolytic therapy for posterior circulation ischemic stroke between October 9, 1993, and February 19, 2001. Main Outcome Measures: National Institutes of Health Stroke Scale, Glasgow Coma Scale, and modified Rankin Scale scores were evaluated at baseline, and the modified Rankin Scale was measured 3 months after stroke, with a good outcome being a modified Rankin Scale score of 2 or less. Results: Nine patients received intravenous therapy; 12 patients received intra-arterial therapy. The median National Institutes of Health Stroke Scale score at onset was 20 (range, 2-39), and the median Glasgow Coma Scale score was 9 (range, 3-15). Twelve patients were treated within 8 hours of symptom onset (range, 11/2 hours to 16 days). Nine patients (43%) had a modified Rankin Scale score of 2 or less at 3 months. The initial Glasgow Coma Scale score and treatment within 8 hours of symptom onset were each associated with good outcome, but the initial National Institutes of Health Stroke Scale score was not predictive. Conclusions: Thrombolytic therapy for posterior circulation stroke may be beneficial even when initiated 8 hours after symptom onset. Level of consciousness, as measured by Glasgow Coma Scale score, seems to be a more important predictor of outcome than the initial National Institutes of Health Stroke Scale score.

Original languageEnglish (US)
Pages (from-to)1126-1129
Number of pages4
JournalArchives of Neurology
Volume62
Issue number7
DOIs
StatePublished - Jul 1 2005
Externally publishedYes

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Glasgow Coma Scale
Stroke
National Institutes of Health (U.S.)
Thrombolytic Therapy
Glasgow
Therapeutics
Consciousness
Ischemia
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)

Cite this

Initial Glasgow Coma Scale score predicts outcome following thrombolysis for posterior circulation stroke. / Tsao, Jack; Hemphill, J. Claude; Johnston, S. Claiborne; Smith, Wade S.; Bonovich, David C.

In: Archives of Neurology, Vol. 62, No. 7, 01.07.2005, p. 1126-1129.

Research output: Contribution to journalArticle

Tsao, Jack ; Hemphill, J. Claude ; Johnston, S. Claiborne ; Smith, Wade S. ; Bonovich, David C. / Initial Glasgow Coma Scale score predicts outcome following thrombolysis for posterior circulation stroke. In: Archives of Neurology. 2005 ; Vol. 62, No. 7. pp. 1126-1129.
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