Prospective pilot study to assess motor activity and the state of the hemostasis system in the acute period of ischemic stroke during systemic thrombolytic therapy

Abstract

OBJECTIVE: The aim: To investigate changes in motor activity and indicators of the state of the hemostasis system in the acute period of ischemic stroke during systemic thrombolytic therapy and without its use. PATIENTS AND METHODS: Materials and methods: We examined 26 male and female patients with a clinical diagnosis of ischemic stroke, who were hospitalized on the first day of the disease to the neurological departments. Patients were divided into 2 groups: group 1-patients who underwent systemic thrombolytic therapy (sTLT) (n=11), group 2-patients who did not receive sTLT (n=15). To compare the coagulogram parameters, 12 healthy patients were examined (control group). Examination of patients was performed on the 1st and 14th day of the disease (clinical examination, assessment of motor activity, coagulation test). Stroke severity was determined by the overall score of the National Institutes of Health Stroke Scale. RESULTS: Results: The average age of patients in group 1 - 60.1±8.2 years old, in group 2 -61.3±5.5 years old. The number of points on the NIHSS scale in group 1 was 8.8±1.13 on 1st day and 3.7±0.79 on 14th day (p<0.05), in group 2 -5.7±0,94 on the 1st day and 3.1±0.93 on the 14th day(p<0.05). The results of the study of the coagulogram indicate a significantly higher level of soluble fibrin-monomer complexes on the 1st day on the 14th day of the ischemic stroke. CONCLUSION: Conclusions: In the acute period of ischemic stroke changes in the hemostasis system reflected the direction of the selected therapy. The use of systematic thrombolytic therapy in ischemic stroke led to a more severe decrease in stroke severity on the NIHSS scale, a significant increase in Barthel index.