[Intravenous thrombolysis patients with acute ischemic stroke--the analysis of the 100 cases. Part II. Neuroimaging, the analysis of hemorrhagic complications and deaths].

Introduction: Computed tomography (CT) remains the basic diagnostic examination in patients with ischaemic stroke. The main purpose of CT examination is distinguishing between hemorrhagic and ischemic stroke, exclusion of other diseases and revealing early ischemic radiological changes.

Material And Methods: The results of baseline CT scans and CT performed on 2nd and 7th days after symptom onset, in terms of patients' long-term outcome, presence of serious adverse events and deaths within 3 months were analyzed.

Results: The analysis included 100 patients treated with rt-PA in stroke unit from September 2006 to April 2009. More than one third of patients had normal baseline CT, in one third--old ischemic changes and in one third--early ischemic changes were revealed. After 3 months the patients who had early changes in baseline CT, and those who had extensive ischemic changes in the area of MCA (middle cerebral artery) or ICA (internal carotid artery) had the worst clinical status. In this group deaths appeared most often (in a subgroup with ischemic signs in the whole territory of MCA, p < 0.01 and in a group of patients with stroke in the ICA territory, p < 0.001), similarly to a group of patients with old changes in baseline CT (34.3% died; p < 0.001) and a group with cerebral edema in control CT (32.4%; p < 0.01). Hemorrhagic transformation appeared in 18% of patients. In this group of patients we found higher risk of death within 3 months after stroke onset(p < 0.001).

Conclusions: The imaging examinations are very important in process of qualification of patients for thrombolytic treatment. Safety of intravenous thrombolysis in patients with ischemic stroke depends on the detailed analyses of the CT scans.