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Combination Therapy with Cytoprotective Agents

  • K. Minematsu
Conference paper

Abstract

Acute ischemic stroke patients often recover spontaneously from the initial deficits [1]. Dramatic improvement following an initial major hemispheric syndrome within minutes to hours after stroke onset, termed as a spectacular shrinking deficit by Mohr and co-workers [2], indicates a migratory embolus in the internal carotid artery territories [3,4]. Many clinical studies have suggested that treatment with thrombolytic agents can promote reopening of the occluded cerebral arteries and may result in better neurological recovery in acute ischemic stroke patients if the treatment is initiated very early after the stroke onset [5–8]. There is, however, a limited time window for successful reperfusion [9–13]. Late reperfusion may cause pronounced brain swelling, hemorrhagic transformation, and a worse outcome than does permanent vascular occlusion [14,15]. Furthermore, thrombolytic agents are likely to increase the risk of hemorrhagic transformation and other hemorrhagic complications [16–19]. Reperfusion, particularly induced by thrombolytic agents, may be a double-edged sword for and against the ischemic brain [20]. Physicians will be likely to hesitate in giving a thombolytic agent to an individual stroke patient, particularly when the patient does not visit the hospital immediately after stroke onset, even if clinical trials going on around the world finally confirm the beneficial effects of thrombolytic therapy.

Keywords

Middle Cerebral Artery Occlusion Acute Ischemic Stroke Thrombolytic Therapy Focal Cerebral Ischemia NMDA Antagonist 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Tokyo 1995

Authors and Affiliations

  • K. Minematsu
    • 1
  1. 1.Cerebrovascular LaboratoryNational Cardiovascular CenterSuita, Osaka, 565Japan

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