Good Outcomes in Ischemic Stroke Patients Treated With Intravenous Thrombolysis Despite Regressing Neurological Symptoms

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Background and Purpose—We evaluated the clinical course of 19 acute stroke patients with rapid early improvement of neurological deficit within the 3-hour window, treated with intravenous thrombolytics.Results—No patient demonstrated a neurological deterioration during hospitalization. National Institutes of Health Stroke Scale (NIHSS) scores at therapy decision and discharge were 5 (4 to 6) and 0.5 (0 to 1.5), respectively. At 3-month follow-up, 1 patient had died; in remaining patients, NIHSS was 0 (0 to 1) and modified Rankin Scale 0.5 (0 to 1; ≤1 in 15 patients).Conclusions—Withholding of intravenous thrombolysis because of spontaneous early regression of neurological symptoms may not be justified.

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