Topics:
Neurology • Vascular Neurology
Would you give TNK or IVT to a patient with proximal occlusion and an NIHSS of 0-3 (non-disabling)?
How about a distal occlusion? The patient was initially symptomatic but symptoms improved or mostly resolved.
Answer from: at Academic Institution
Yes, for sure. Disabling is relative and if there is occlusion, it will get worse later on if we don’t open it now with either TPA or TNK when we can’t give them.
It is always good to do CT perfusion in these cases, likely, the occlusion is chronic and there are good collaterals that ha...
Answer from: at Academic Institution
Yes, if the stroke is disabling at all, I would give TNK. Whether or not TNK is given, the patient should be monitored very closely and mechanical thrombectomy should be offered if the deficit worsens.
Answer from: at Academic Institution
Indeed. I would start the meds. We always look for a reason "to give" and not withhold clot "busters".
Answer from: at Community Practice
I would give TNK if the patient has NIHSS 1-2 with sxs of Broca’s aphasia, mild rt. NLFD, left ICA occlusion, and CT perfusion scan is not available if the patient is still within the therapeutic window and meets all-inclusive criteria.
Comments
at University of Colorado, Climate & Health Dept
I give TNK with almost any symptom (excluding dizz...
I give TNK with almost any symptom (excluding dizz...
Excellent synopsis and I wholeheartedly agree.
Thank you, Dr. @Teitcher. I appreciate your though...
Very helpful.
There are lots of abbreviations being used. I woul...
NIHSS: National Institute of Health Stroke Scale ...
Thank you, Dr. @Martucci for clarifying.
Since this popped back up in my inbox, just a quic...
It was standard policy at our tertiary care center...
The key is to always "look for a reason to give th...