The effect of the thrombolytic therapy on the early rehabilitation of patients with acute ischemic stroke – study report

Abstract

Introduction. r-TPA intravenous thrombolytic therapy is a big step in acute management of ischemic stroke (IS) but is burdened by a small therapeutic window (max. 4.5 hours) that restricts patient access. NIH stroke scale (NIHSS) is the largest worldwide tool used by doctors in order to objectively quantify the severity of neurological impairment in acute IS, in the initial stage as well as in the subsequent stages. Material and method. The aim of this paper is to present the results of an observational, prospective, analytical study on a number of 110 patients with acute IS, hospitalized within two months in the Neurology Clinic of Sibiu (19 patients with thrombolytic therapy applied, 91 patients with classic therapy). NIHSS has been applied to all patients on the first day of the admission and at the discharge date. Results and discussions. The mean value of NIHSS at admission and at discharge (A/D) were 12,84/4.06 points for the patient with thrombolytic therapy and 7,73/4,45 points for the patients without thrombolytic therapy. In hospital NIHSS score reduction, meaning early recovery of patients, was consistent with type of applied therapy (8.78 vs3.28 points). The pattern of neurological impairment is specific for each subtype of IS. Conclusions. The degree of early recovery was superior for patients with versus without thrombolytic therapy (68.4% versus 42.4%). Average hospital care period was reduced with 8,33% for patients with thrombolytic therapy (11,4 versus 12,2 days care in hospital). Keywords: ischemic stroke, early rehabilitation, NIH stroke scale, neurological pattern,