Acute stroke: we have the treatments and we have the evidence--we need to use them.
Despite huge global burden, stroke disease has traditionally received little attention in the general medical press. We review a series of four acute stroke research articles published in a themed issue of the Lancet. Claiborne-Johnston and coworkers presented a scoring system to stratify risk of stroke following transient ischaemic attack. Chalela and colleagues demonstrated that magnetic resonance imaging is superior to computed tomography in detecting acute ischaemic stroke and that fears of missing intracranial haemorrhage are unfounded. The SITS-MOST (Safe Implementation of Thrombolysis in Stroke - Monitoring Study) group reported positive experience of translating acute stroke thrombolysis trials into routine clinical practice in Europe, and the PROSIT (Project on Stroke Services in Italy) group studied acute effects of admission to a dedicated stroke unit. The message from all of these reports is that evidence-based, successful management of acute stroke is possible, and that investment in health infrastructure and changing mind sets of health practitioners to improve stroke care will deliver benefits.
Quinn
Terence J
TJ
Gardiner Institute of Cardiovascular and Medical Sciences, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, UK. Tjq1t@clinmed.gla.ac.uk
Dawson
Jesse
J
Lees
Kennedy R
KR
D019317:Evidence-Based Medicine; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications; D008279:Magnetic Resonance Imaging; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000145:classification* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
D010959:Tissue Plasminogen Activator