Document Detail


Acute ischaemic stroke: revascularizing therapy. Stroke Council of the American Heart Association.
MedLine Citation:
PMID:  9758293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The principal goals of thrombolytic therapy for stroke are early restitution of cerebral blood flow, reduction of ischaemia, and attenuation of neurological disability through lysis of an occluding thrombus and consequent rapid restoration of circulation in the affected territory. Therapy should be initiated as soon as possible, at least within 4-6 h of stroke onset, to prevent major infarction and to salvage the hypoperfused but potentially viable zone adjacent to the central ischaemic area known as the ischaemic penumbra. This survey focuses on the safety and efficacy of thrombolytic therapy in acute ischaemic stroke in clinical trials. The results of two successful major randomized studies using tissue plasminogen activator (t-PA) were recently published. Intravenous thrombolysis seemed to be effective in improving functional and neurological outcome in a clearly defined subgroup of patients meeting the inclusion criteria of the studies. However, the identification of those patients proved to be difficult and depended on expertise in recognizing the early infarction signs on initial computed tomography. Since treating ineligible patients is associated with an unacceptable risk of intracranial bleeding complications and death, intravenous thrombolysis should only be performed at selected centres in selected patients.
Authors:
M Spranger; T Steiner; S Schwab; W Hacke
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Publication Detail:
Type:  Guideline; Journal Article; Practice Guideline; Review    
Journal Detail:
Title:  Journal of neurology     Volume:  245     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-12-10     Completed Date:  1998-12-10     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  567-72     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Heidelberg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Cerebral Revascularization*
Fibrinolytic Agents / therapeutic use
Humans
Ischemic Attack, Transient / therapy*
Randomized Controlled Trials as Topic
Recombinant Proteins / therapeutic use
Thrombolytic Therapy* / adverse effects
Tissue Plasminogen Activator / therapeutic use
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Recombinant Proteins; EC 3.4.21.68/Tissue Plasminogen Activator

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