Comparison of pharmacological induced hypertension and anticoagulation for rescue therapy of early neurological deterioration in lacunar stroke

초록

Purpose: The early neurological deterioration (END) has occurred by various causes in many patients with acute ischemic stroke. Although pharmacologically induced hypertension (PIH) and the anticoagulant, Methods: Among the prospective registry of the patients with acute ischemic stroke, admitted to our hospital between April 2014 and August 2021, we reviewed the subjects with lacunar stroke who received the PIH or intravenous infusion of argatroban for rescue therapy of END within 3 days of symptom onset. In the PIH group, phenylephrine was administered intravenously over 24 hours and tapered off slowly when the symptoms improved or after 4 days of PIH. In the anticoagulation group, argatroban was administered intravenously for 4 days. We compared the END recovery defined as the improvement of NIHSS down to the ones on admission, the excellent outcomes (0 or 1 mRS at 3 months), and the safety profile.