What is the role of thrombolysis in acute stroke ?
Treatment with intravenous tissue plasminogen activator (tPA) when administered within 3 hours after onset of the ischaemic event (and in the absence of any sign of brain injury on CT) improves clinical outcome at 3 months (N Engl J Med 1995; 333: 1581-7). The CT scan in these patients must be examined very carefully for evidence of hemispheric brain ischaemia, which may increase the risk of deterio-ration, with or without cerebral haemorrhage, after thrombolytic treatment. An over-view of previous trials found significant excesses of early and total deaths, and of symptomatic and fatal intracranial haemorrhages, after acute thrombolysis, but a significant reduction in death or dependency in patients randomized to treatment within 3 hours of stroke onset (Lancet 1997; 350: 607-14). It remains unclear which patients are most likely to benefit or be harmed.
Lexo edhe:
Treatment with intravenous tissue plasminogen activator (tPA) when administered within 3 hours after onset of the ischaemic event (and in the absence of any sign of brain injury on CT) improves clinical outcome at 3 months (N Engl J Med 1995; 333: 1581-7). The CT scan in these patients must be examined very carefully for evidence of hemispheric brain ischaemia, which may increase the risk of deterio-ration, with or without cerebral haemorrhage, after thrombolytic treatment. An over-view of previous trials found significant excesses of early and total deaths, and of symptomatic and fatal intracranial haemorrhages, after acute thrombolysis, but a significant reduction in death or dependency in patients randomized to treatment within 3 hours of stroke onset (Lancet 1997; 350: 607-14). It remains unclear which patients are most likely to benefit or be harmed.
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