Annals of Indian Academy of Neurology
REVIEW ARTICLE
Year
: 2008  |  Volume : 11  |  Issue : 5  |  Page : 24--29

Intravenous thrombolytic therapy in acute ischemic stroke: The art and science of treatment decision making


PN Sylaja1, Andrew M Demchuk2 
1 Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
2 Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada

Correspondence Address:
P N Sylaja
Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala
India

Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) within 3 h of symptom onset is currently approved for treatment of acute ischemic stroke. Those who present within 3 h and have a vascular occlusion and a good CT scan are the ideal candidates for thrombolysis. Clinical trials and phase IV data has shed substantial light on the factors associated with more favorable outcomes with tPA. In the 3-6 h time window, cerebral perfusion information can be used for selection of patients for thrombolytic therapy. In many special circumstances, such as seizure at stroke onset, stroke on awakening, age more than 80 years, and patients with rapidly improving symptoms, the decision to treat depends on expert judgment. Due to the narrow time window, the fear of bleeding complications, and doubts regarding its effectiveness, tPA is still underused. Constant efforts are required to educate the public on the fact that stroke is a treatable emergency.


How to cite this article:
Sylaja P N, Demchuk AM. Intravenous thrombolytic therapy in acute ischemic stroke: The art and science of treatment decision making.Ann Indian Acad Neurol 2008;11:24-29


How to cite this URL:
Sylaja P N, Demchuk AM. Intravenous thrombolytic therapy in acute ischemic stroke: The art and science of treatment decision making. Ann Indian Acad Neurol [serial online] 2008 [cited 2020 Sep 18 ];11:24-29
Available from: http://www.annalsofian.org/article.asp?issn=0972-2327;year=2008;volume=11;issue=5;spage=24;epage=29;aulast=Sylaja;type=0