Stroke therapy

R. M. Post and co-workers, ia B. S. Meldmm and M. WiUiams, eds.. Current and Euture Trends in A.nticonvulsant, A.nxiety, and Stroke Therapy,... 

The second hypothesis, that patients should be selected for thrombolysis depending on whether or not they exhibit a diffusion-perfusion mismatch, may have enormous implications for stroke therapy in the near future, and is one of the most actively investigated and debated subjects in neuroimaging. 

The combined experience with IV rt-PA treatment beyond 3 hours, therefore, suggests reduced effectiveness compared to treatment within 3 hours. A pooled analysis of the ATLANTIS, ECASS, and NINDS rt-PA studies confirmed that the odds of a favorable 3-month outcome, defined as minimal or no poststroke disability on the BI, mRS, and NIHSS, decreased with increasing stroke onset to start of treatment time (OTT) (p = 0.005). The odds ratios for favorable outcome with rt-PA treatment were 2.8 (95% Cl 1.8. 5) for OTT 0-90 minutes, 1.6 (95% Cl 1.1-2.2) for 91-180 minutes, 1.4 (95% Cl 1.1-1.9) for 181-270 minutes, and 1.2 (95% Cl 0.9-1.5) for 271-360 minutes. This finding, that earlier treatment is associated with more therapeutic efficacy, supports the adage that in the delivery of acute stroke therapy time is brain. " The rate of sICH was not associated with OTT. ... 

Alternatives to Plasminogen Activation Other Thrombolytics Thrombolytics currently in the market are plasminogen activators. Therefore, their activity is impacted by the amount of plasminogen in the thrombus. New drugs that do not depend on the availably of plasminogen are currently being evaluated for stroke therapy. 

NONTHROMBOLYTIC ACUTE STROKE THERAPIES 3-Month mRs by ALB dose-tier tPA cohofl... 

Eisher M, Albers GW, Donnan GA, Eurlan AJ, Grotta JC, Kidwell CS, Sacco RL, Wechsler LR. Enhancing the development and approval of acute stroke therapies stroke therapy academic industry roundtable. Stroke 2005 36 1808-1813. 

Saver XL, Kidwell C, Eckstein M, Starkman S. Prehospital neuroprotective therapy for acute stroke results of the field administration of stroke therapy-magnesium (fast-mag) pilot trial. Stroke 2004 35 el06-el08. 

Lyden PD, Jackson-Friedman C, Shin C, Hassid S. Synergistic combinatorial stroke therapy a quantal bioassay of a gaba agonist and a glutamate antagonist. Exp Neurol 2000 163 477 89. 

ACUTE STROKE THERAPY WITH OTHER ANTIPEATEEET AGENTS... 

A number of evidence-based guidelines exist to help choose appropriate acute stroke therapy. 

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