急性后循环梗死的管理刘丽萍.ppt

Relation of stroke onset to start of treatment (OTT) with treatment effect after adjustment for prognostic variables assessed by (A) day 90 modified Rankin score 0–1 versus 2–6 (interaction p=0·0269, n=3530 [excluding EPITHET7 data p=0·0116, n=3431]); (B) global test that incorporates modified Rankin score 0–1 versus 2–6, Barthel Index score 95–100 versus 90 or lower and NIHSS score 0–1 versus 2 or more (interaction p=0·0111, n=3535 [excluding EPITHET7 data p=0·0049, n=3436]); (C) mortality (interaction p=0·0444, n=3530 [excluding EPITHET7 data p=0·0582, n=3431]); and (D) parenchymal haemorrhage type 2 (interaction p=0·4140, n=3531 [excluding EPITHET7 data p=0·4578, n=3431]). Thus, for parenchymal haemorrhage type 2, the fi tted line is not statistically distinguishable from a horizontal line. For each graph, the adjusted odds ratio is shown with the 95% CIs. CIs from the models will diff er from those shown in the tables because the model uses data from all patients treated within 0–360 min whereas the categorised analyses in the tables are based on subsets of patients: the modelled CIs are deemed to be more reliable. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials 分析开始溶栓治疗时间与安慰剂对照组预后差异，4.5小时内溶栓有效改善预后 4.5小时内安慰剂组与溶栓治疗组死亡率无差异，4.5小时以上溶栓组死亡率差异增加 筛选 1,020例患者中的 74例， 发病3-6小时行rTPA溶栓治疗，完成急性期头核磁（序列包括DWI PWI MRA T1 GRE ）,30天MRS评分作为观察指标 “Mismatch” PWI病灶超过DWI病灶 10ml或120% “No Mismatch” PWI 小于DWI的120% “Malignant profile,”广泛DWI和或广泛PWI病灶 Target Mismatch 适宜评价早期再灌注的排除了恶性Mismatch者 - * k * * Case 3. A and B, Vermian hematoma (small arrows) with peripheral edema has compressed and deformed quadrigeminal plate cistern (large arrow). C and 0, Adjacent CT section shows flattening and amputation or “squaring off” of posterior point of cerebrospinal fluid rhomboid (arrow). * Case 2. A and B, Large vermian metastasis with edema. C and 0, More superior level discloses moderate posterior compression a