title: Intravenous rt-PA for stroke.
abstract: Thrombolytic therapy remains the most potent known treatment for acute ischaemic stroke. Treatment can significantly improve neurological outcome with only a mild increase in haemorrhage risk. Previous concerns over the importance of subtle CT detect early infarct signs appears unwarranted. Most patients with a significant neurological deficit and without evidence of haemorrhage on initial head imaging in the < 3 h window should be considered for treatment. Subgroup analysis suggests that even patients with severe strokes and early signs of cerebral ischaemia on CT may benefit from treatment, albeit to a lesser degree. Community based studies indicate that a similar degree of efficacy can be achieved in routine clinical practice, especially at centres experienced at thrombolytic administration. Treatment beyond 3 h may also be efficacious in selected cases, but further clinical trials are necessary before routine use in this time period can be advocated.
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D007262:Infusions, Intravenous; D015337:Multicenter Studies as Topic; D020521:Stroke / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator