BMJ 2003;326:233-234 ( 1 February )

Editorials

Therapeutic thrombolysis for acute ischaemic stroke

What is good for heart attacks is still not good enough for brain attacks

The first 150 words of the full text of this article appear below.

Therapeutic thrombolysis for acute myocardial infarction is standard practice, but not so for ischaemic stroke, the "brain attack" equivalent of heart attack. This is partly because stroke is more complicated: intracerebral haemorrhage must be excluded by imaging, and more vascular pathologies than atheroma underly ischaemic stroke (for example, intracranial small vessel disease and embolism from the heart). Furthermore, coronary care units make research on heart attacks relatively easy, whereas research on acute stroke still often takes place in general medical wards. With stroke units, this will be less of a problem. Research on strokes is woefully underfunded in comparison to research on heart attacks.1 But, if thrombolytic "unblocking the pipes" works for acutely occluded coronary arteries, it should work for acutely occluded brain arteries, provided reperfusion does not make matters worse by increasing cerebral oedema and haemorrhagic transformation. As usual, the balance of benefit and risk is best determined by . . . [Full text of this article]
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

This article has been cited by other articles:

  • Rocco, A., Pasquini, M., Cecconi, E., Sirimarco, G., Ricciardi, M. C., Vicenzini, E., Altieri, M., Di Piero, V., Lenzi, G. L. (2007). Monitoring After the Acute Stage of Stroke: A Prospective Study. Stroke 38: 1225-1228 [Abstract] [Full text]  
  • Bandera, E., Botteri, M., Minelli, C., Sutton, A., Abrams, K. R., Latronico, N. (2006). Cerebral Blood Flow Threshold of Ischemic Penumbra and Infarct Core in Acute Ischemic Stroke: A Systematic Review. Stroke 37: 1334-1339 [Abstract] [Full text]  
  • van Oostenbrugge, R J, Hupperts, R M M, Lodder, J (2006). Thrombolysis for acute stroke with special emphasis on the very old: experience from a single Dutch centre.. J. Neurol. Neurosurg. Psychiatry 77: 375-377 [Abstract] [Full text]  
  • Heuschmann, P. U., Kolominsky-Rabas, P. L., Roether, J., Misselwitz, B., Lowitzsch, K., Heidrich, J., Hermanek, P., Leffmann, C., Sitzer, M., Biegler, M., Buecker-Nott, H.-J., Berger, K., for the German Stroke Registers Study Group, (2004). Predictors of In-Hospital Mortality in Patients With Acute Ischemic Stroke Treated With Thrombolytic Therapy. JAMA 292: 1831-1838 [Abstract] [Full text]  
  • Watson, T W J, Simon, J E, Buchan, A M (2003). Stroke care: the way forward. J. Neurol. Neurosurg. Psychiatry 74: 411-412 [Full text]  

Rapid Responses:

Read all Rapid Responses

Preventive Treatment for Patients with Cerebral Ischemia--and Macular Degeneration: What to Do?
Nancy Yanes-Hoffman
bmj.com, 1 Feb 2003 [Full text]
Problems with thrombolysis in ischemic stroke
ashish aneja
bmj.com, 5 Feb 2003 [Full text]
Thrombolysis for acute ischaemic stroke in the accident and emergency department
Omar Quaba, et al.
bmj.com, 6 Feb 2003 [Full text]
First do no harm
Richard G Fiddian-Green
bmj.com, 6 Feb 2003 [Full text]
Waiting for Confirmation
Michael J. Beyak
bmj.com, 13 Feb 2003 [Full text]
thrombolysis in ischaemic stroke.
dr.manan vasenwala
bmj.com, 23 Jul 2003 [Full text]
Zero tolerance for complications and deaths from medical therapy.
Richard G Fiddian-Green
bmj.com, 25 Jul 2003 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ