Tirofiban treatment in two cases of acute ischemic stroke with early neurological deterioration after intravenous thrombolysis with rt-PA
10.3969/j.issn.1002-0152.2025.04.006
- VernacularTitle:替罗非班治疗急性缺血性脑卒中rt-PA静脉溶栓后早期神经功能恶化2例
- Author:
Jianhua ZHENG
1
;
Yanling CUI
1
;
Hanwen HU
1
;
Ying CAO
1
;
Jianwu DAI
1
Author Information
1. 广州市第十二人民医院神经内科(广州 510620)
- Publication Type:Journal Article
- Keywords:
Acute ischemic stroke;
rt-PA;
Intravenous thrombolysis;
Tirofiban;
Aspirin;
Clopidogrel
- From:
Chinese Journal of Nervous and Mental Diseases
2025;51(4):240-243
- CountryChina
- Language:Chinese
-
Abstract:
Early neurological deterioration(END)occurs in patients with acute cerebral infarction after recombinant tissue-plasminogen activator(rt-PA)intravenous thrombolysis,which seriously affects the prognosis of patients and even causes death.However,there is no effective treatment.This report describes two patients with acute ischemic stroke presenting with right-sided limb weakness within 4.5 hours of onset.Brain CT ruled out cerebral hemorrhage and both patients were diagnosed with acute ischemic stroke.END occurred within 24 hours after intravenous thrombolysis with rt-PA.Reexamine Brain CT showed no evidence of cerebral hemorrhage.The patients were treated with continuous tirofiban infusion for 48 hours,overlapping with oral antiplatelet therapy for 4 hours and 6 hours,respectively.After discontinuation of tirofiban,no further neurological deterioration was observed.At the 3-month follow-up,there was no recurrence,and the modified Rankin scale(mRS)scores were 1 and 3,respectively.This study delineates the diagnostic and therapeutic trajectories of two paradigmatic cases to inform clinical decision-making for analogous presentations,thereby contributing to evidence-based management strategies.
