Document Detail

The future of stroke treatment.
MedLine Citation:
PMID:  10757838     Owner:  NLM     Status:  MEDLINE    
The concept of the therapeutic window of opportunity in ischemic neuronal injury and understanding the necessity of well organized stroke services revolutionized the management of acute ischemic stroke during the last years of the second millennium. Thrombolysis with IV rt-PA within 3 hours from the onset of symptoms is an established therapy for selected patients. The challenge of stroke therapy at the outset of this millennium is how to translate basic pathophysiologic evidence of ischemic neuronal injury into novel neuroprotective therapies either independently or combined with thrombolysis. Great hopes are placed in identification of pivotal molecular events in ischemic brain tissue and design of effective pharmacological interventions to target them. Aggressive, invasive procedures are also being developed and therapies such as intra-arterial clot lysis, hemicraniectomy and mild hypothermia may improve the bleakest outcomes associated with the most severe forms of ischemic stroke, but their role must be rigorously evaluated. There is, however, no need to wait for future breakthroughs. The existing evidence strongly implies that good care of patients with stroke starts with organization of the entire stroke chain; from the prehospital scene, through the emergency room, to the stroke unit. Without structured stroke services no pharmacological or intervening therapy is likely to improve the outcome of the patient with a stroke.
P J Lindsberg; R O Roine; T Tatlisumak; T Sairanen; M Kaste
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurologic clinics     Volume:  18     ISSN:  0733-8619     ISO Abbreviation:  Neurol Clin     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-06-21     Completed Date:  2000-06-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8219232     Medline TA:  Neurol Clin     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  495-510     Citation Subset:  IM    
Senior Staff Neurologist, Department of Clinical Neurosciences, Helsinki University Central Hospital, Helsinki, Finland.
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MeSH Terms
Stroke / etiology,  therapy*
Treatment Outcome

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