Early Thrombolysis May Help Cut Pontine Stroke Decline

TOPLINE:

Intravenous thrombolysis (IVT) administered within 4.5 hours was linked to significantly lower risk for neurological deterioration in acute pontine infarction than other antithrombotic therapies, new research shows.

METHODOLOGY:

• Researchers retrospectively enrolled consecutive patients admitted within 4.5 hours after the onset of isolated pontine infarction, confirmed through diffusion-weighted MRI.
• Overall, 211 patients with acute isolated pontine infarction (median age, 67 years; 63% men) were assigned to receive IVT (n = 74) or non-IVT antithrombotic treatment (n = 137), including antiplatelet or anticoagulant therapy.
• Neurological deterioration was defined as a ≥ 2-point increase in the National Institutes of Health Stroke Scale (NIHSS) score between the maximal and initial neurological deficits during hospitalization.
• The IVT group had a higher NIHSS score at admission than the non-IVT group (7 vs 4), but scores at discharge were similar (4 vs 5).

TAKEAWAY:

• Neurological deterioration occurred in significantly fewer patients in the IVT group compared to the non-IVT group (23% vs 37%; P = .04).
• IVT was identified as an independent factor in preventing ND (odds ratio, 1.5; P = .04).
• The incidence of intracranial hemorrhagic transformation and major visceral organ hemorrhage did not differ significantly between the groups.

IN PRACTICE:

“IVT did not increase the incidence of major bleeding events, which indicated that the administration of IVT to these patients appeared to be safe. Therefore, clinicians should recommend IVT for patients with suspected pontine infarction, even if their neurological deficits are mild within 4.5 h after onset,” the investigators wrote.

SOURCE:

The study was led by Zhenxiao Chai, the Third Affiliated Hospital of Wenzhou Medical University, Ruian, China. It was published online on January 22 in Frontiers in Neurology.

LIMITATIONS:

The retrospective study had a modest sample size, which may have affected the generalizability of the results. Repeat MRI was not performed after neurological deterioration in most patients, preventing the confirmation of the exact cause of progression through imaging studies.

DISCLOSURES:

The study was supported in part by grants from the Wenzhou Medical and Health Science Research Foundation and the Wenzhou Basic Scientific Research Project Foundation. The investigators reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.