title: Open label tissue plasminogen activator for stroke: the Oregon experience.
abstract: BACKGROUND
  Tissue plasminogen activator (t-PA) is the first effective treatment for stroke. This study sought to explore the outcome of patients treated with t-PA in the community after approval of its use in the treatment of stroke in June, 1996.
  
  
  METHODS
  All patients with acute stroke within the 6-hospital Oregon Stroke Center network were screened for potential t-PA treatment. Baseline and 24-hour outcome assessments were performed with the use of the National Institutes of Health Stroke Scale (NIHSS) and computed tomography (CT); 3-month outcome was evaluated by using the Modified Rankin scale.
  
  
  RESULTS
  Thirty-three patients who met the criteria for t-PA therapy were treated within 3 hours of symptom onset. All but 2 strokes were in the anterior circulation; 48.5% were cardioembolic. The NIHSS scores at 24 hours after administration of t-PA (mean, 14.7) showed modest gains from baseline NIHSS scores (mean, 16.6). Twelve patients (36%) had minimal or no deficits at 3 months. Three patients (9%), all of whom had baseline NIHSS scores of 20 or more, had symptomatic intracranial hemorrhages, 2 of which were fatal (6%).
  
  
  CONCLUSIONS
  This study shows the feasibility of treating acute stroke with t-PA in the community. The percentage of fully recovered patients at 3 months mirrored those in the National Institute of Neurologic Disorders and Stroke (NINDS) trial.
authors: R
authors: R
authors: Egan
authors: H L
authors: HL
authors: Lutsep
authors: W M
authors: WM
authors: Clark
authors: J
authors: J
authors: Quinn
authors: K
authors: K
authors: Kearns
authors: A
authors: A
authors: Lockfeld
authors: S
authors: S
authors: Ireland
authors: S
authors: S
authors: Goins
authors: G
authors: G
authors: Buchholz