Thrombolysis and Treatment of Acute Stroke

  • Pearse Morris


The ideal treatment for ischemic stroke involves removal of vascular obstruction, protection of the injured brain, and restoration of function. Irreversible brain injury probably begins about 5 minutes after onset of complete global ischemia, which does not allow much scope for completely effective therapy.1 However, degrees of ischemia and vascular occlusion are variable in symptomatic patients, which means that some stroke patients can be helped considerably by aggressive treatment within the first few hours of onset. Measures aimed at improving perfusion pressure within the affected area of brain should be effective at limiting the degree of tissue damage following an ischemic event. The most obviously effective strategy would involve removal of the occlusive lesion (Fig. 13.1). Therefore, the possibility of thrombolytic therapy by intravenous and intraarterial routes has been examined in a number of trials. The earliest trials involved use of intravenous streptokinase administered to patients within periods up to 4 days following stroke. Treated groups of patients demonstrated poorer outcomes and higher rates of hemorrhagic transformation compared with controls.2


Middle Cerebral Artery Acute Stroke Acute Ischemic Stroke Basilar Artery Thrombolytic Agent 
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© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Pearse Morris
    • 1
  1. 1.School of MedicineWake Forest UniversityWinston-SalemUSA

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