Clinical Analysis of Intravenous Thrombolysis in Anterior Choroidal Artery Territory Stroke

Duan Honglian; Du Huishan; Meng Fanhua; Tong Yanna; Wang Yanling

doi:10.3969/j.issn.1672-1349.2017.06.007

Abstract：Objective To explore the clinical characteristics and the effect of intravenous thrombolysis therapy of the anterior choroidal artery (AChA) territory stroke.Methods Retrospective analysis of 23 cases of AChA territoty stroke confirmed by magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI), which was divied into unprogressive group and progressive group,the clinical features,fluctuation factors, effects of actilyse (recombinant human tissue plasminogen activator for injection, rt-PA), and prognosis for 90 days were analyzed.Results Twenty-three cases were given rt-PA intravenous thrombolytic therapy in 4.5 hours after clinical onset, 6 cases symptoms stabilized or improvement after treatment.The symptoms of 17 patients are fluctuate within the first 3 days of the onset of symptoms.Patients with diabetes mellitus were more prone to disease progression.There was statistic difference in National Institutes of Health Stroke Scale (NIHSS) score between unprogressive group and progressive group at discharge (P<0.05).NIHSS score in progressive group was higher than that in unprogressive group.There was statistic difference in modified Rankin scale (mRS) score after 90 days of onset between unprogressive group and progressive group.The rate of good prognosis was 88.2% in progressive group and 100% in the other group.Conclusion Motor function damage is the main clinical manifestations in patients of AChA infarction.73.9% of patients had symptomatic fluctuations or aggravation within the first 3 days of onset.Rt-PA itrravenous thrombolysis should be applicated actively because the good prognosis at 90 days after onset.