Intravenous thrombolysis for acute stroke
Citation Manager Formats
Make Comment
See Comments
![Loading Loading](https://n.neurology.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif)
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Until recently there was no specific therapy for stroke, but the recent publication of the National Institute of Neurological Disorders and Stroke(NINDS) t-PA for Acute Stroke Trial presents the first effective, specific therapy for stroke.1 In considering whether to apply thrombolysis to any given patient, the physician must consider the factors unique to each patient and the scientific literature regarding the therapy. We now review the literature that preceded the publication of the NINDS study to put the positive results into perspective.
We selected papers for inclusion in our review in two ways. First, we collected the pivotal works known to one or more of the authors. Second, we performed a Medline retrieval for the years 1966 to 1996 using the search terms cerebrovascular disorders and human thrombolytic therapy, excluding references with the terms myocardial infarction or coronary angiography. We also excluded papers not written primarily in English. This search yielded 178 references. We carefully examined the titles and subject words. We eliminated 32 that appeared to be letters or editorials, 46 that appeared to be review articles with no original data, 10 that were case reports of one or a few patients, 23 that addressed the use of intra-arterial thrombolysis, and 53 that were concerned with other uses of thrombolysis such as removing intracerebral hematomas or preventing vasospasm. We retrieved, critically reviewed, and categorized the 14 remaining papers using the criteria listed in table 1.
- In this window
- In a new window
Table 1 Criteria used for categorizing publications reviewed here
Rationale for cerebral artery thrombolysis. It has been assumed from the earliest writings on stroke and confirmed in recent studies employing vascular imaging techniques that most ischemic strokes result from vascular occlusion caused by thrombus.2,3 In a small minority of cases, ischemia may be caused by other mechanisms such as vasospasm. The …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Dennis Bourdette and Dr. Lindsey Wooliscroft
► Watch
Related Articles
- No related articles found.
Alert Me
Recommended articles
-
Articles
Effectiveness of t-PA in acute ischemic strokeOutcome relates to appropriatenessA.M. Buchan, P.A. Barber, N. Newcommon et al.Neurology, February 08, 2000 -
Articles
rtPA in acute ischemic strokeEuropean perspectiveWerner Hacke et al.Neurology, November 01, 1997 -
Articles
Efficacy of IV tissue plasminogen activator in acute strokeDoes stroke subtype really matter?A. W. Hsia, H. S. Sachdev, J. Tomlinson et al.Neurology, July 08, 2003 -
Articles
rtPA in acute ischemic strokethe North American perspectiveLewis B. Morgenstern et al.Neurology, November 01, 1997