Vascular aphasia outcome after intravenous recombinant tissue plasminogen activator thrombolysis for ischemic stroke

Eur Neurol. 2014;71(5-6):288-95. doi: 10.1159/000357428. Epub 2014 Feb 26.

Abstract

Introduction: No data about the specific outcome of aphasia after thrombolysis are available. Our aim was to describe the severity and type of aphasia after stroke thrombolysis.

Methods: This retrospective cohort study included consecutive aphasic patients hospitalized in the Stroke Unit of Dijon (University Hospital, France) between 2004 and 2009 for a first-ever ischemic stroke of the left middle cerebral artery. Aphasic syndromes and their severity (French version of the Boston Diagnostic Aphasia Examination) were evaluated during the first week and 3 months after stroke.

Results: In multivariate analyses, the severity of aphasia in the 37 thrombolysed patients was milder than in the 38 nonthrombolysed patients during the first week (adjusted OR = 10.13, 95% CI: 2.43-42.28, p = 0.002) and at 3 months (adjusted OR = 8.44, 95% CI: 2.76-25.80, p = 0.001). The frequency of mild aphasia (conduction or atypical) was not significantly higher in thrombolysed patients during the first week after stroke (adjusted OR = 5.80, 95% CI: 0.82-41.16, p = 0.079).

Conclusion: The severity of aphasia during the first week and 3 months after stroke is milder in thrombolysed than in nonthrombolysed patients, perhaps because of a greater frequency of conduction and mild atypical aphasia.

MeSH terms

  • Aged
  • Aphasia / diagnosis
  • Aphasia / etiology*
  • Brain Ischemia / complications
  • Brain Ischemia / drug therapy
  • Female
  • Fibrinolytic Agents / adverse effects
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Infarction, Middle Cerebral Artery / complications*
  • Infarction, Middle Cerebral Artery / drug therapy*
  • Language Tests
  • Male
  • Multivariate Analysis
  • Retrospective Studies
  • Severity of Illness Index
  • Stroke / complications
  • Stroke / drug therapy
  • Thrombolytic Therapy* / adverse effects
  • Time Factors
  • Tissue Plasminogen Activator / adverse effects
  • Tissue Plasminogen Activator / therapeutic use*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator