Abstract

Stroke is one of the most common causes of morbidity, mortality, in developed as well as in developing countries. Stroke patients are at highest risk death in the first few weeks after the event, and between 20-50% die within first month depending on type, severity, age, co-morbidities and effectiveness of treatment of complications. Aim of this study was to clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase). Material and Methods: Prospective Observational study of 30 cases of acute ischemic stroke receiving IV thrombolysis using rtPAalteplase at Tertiary care Institute of Gujarat, India. NIHSS score was assessed 24 hours after thrombolysis for all the subjects. Results: 25 cases received a dose of rtPA 0.6 mg/kg body weight. 10% of total dose is given as bolus, remaining as infusion over 1 hour. 5 cases received 20 mg of IV rtPA, of which 2 cases was already on dual antiplatelets, 2 cases was on anti-platelet plus oral anticoagulant, 1 case was more than 80 years of age. Primary outcome is defined as NIHSS reduction by at least 4 points, 24 hours of after thrombolysis. 18 subjects had achieved primary outcome in this study. Secondary outcome was measured with MRS Score after 3 months of thrombolysis. MRS Score of 0 to 2 is considered as favorable outcome. In this study 23 subjects (76.66 %) had favorable outcome at the end of 3 months. Conclusion: Stroke being a medical emergency should be treated as fast as possible. Creating awareness among local population will help in reducing the time taken for bringing the patient to hospital. An organized stroke team will help in reducing door to needle time. Advanced techniques like endovascular thrombolysis will help in few cases.

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