The very acute stroke treatment: fibrinolysis and after.
Thrombolytic therapy with rt-PA given within 3 h after stroke onset to patients with ischemic stroke significantly improves outcome after stroke. There are some evidences that thrombolysis may also work up to 6 h after stroke onset in carefully identified patients, but the three most important trials, which used 0-6 h time-windows, combined with CT-scans to define the ischemic areas, failed individually to produce statistical benefits for the rt-PA-treated patients. In order to enlarge the time-window there is a need for additional information about the functionality of the affected brain area. There is a growing interest in the use of Diffusion Weighted (magnetic resonance) imaging (DWI) and Perfusion Weighted (magnetic resonance) imaging (PWI) in the assessment of patients with acute ischemic stroke. These magnetic resonance techniques are powerful methods for identifying the extent and location of early cerebral ischemia.
Caso
Valeria
V
Dipartimento di Neuroscienze, University of Perugia, Perugia, Italy. vcaso@hotmail.com
Hacke
Werner
W
D001783:Blood Flow Velocity / Q000502:physiology; D002545:Brain Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D002986:Clinical Trials as Topic; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D015424:Reperfusion; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator