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TitleThrombolytic Therapy for Stroke [electronic resource] / edited by Patrick D. Lyden
ImprintTotowa, NJ : Humana Press : Imprint: Humana Press, 2001
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Descript XIV, 410 p. online resource


Tissue plasminogen activator (t-PA) is the only treatment currently proven to benefit stroke victims, but no physician guide to its safe and proper use exists. In Thrombolytic Therapy for Stroke, the world's leading experts detail the basic rationale, scientific evidence, and treatment protocol for thrombolytic therapy in acute stroke patients. These experienced clinicians show how promptly delivered thrombolysis can restore cerebral blood flow in time to salvage brain and neurologic function, first by reviewing the preclinical development of thrombolytics, and then by presenting the pivotal clinical trials that proved their efficacy and safety. Their description of the treatment protocol discusses field triage and management, emergency department therapy, brain imaging, clinical decision making and patient selection, drug administration, post--thrombolysis management, and the treatment of complications. Real-life programmed case histories-complete with commentary and brain images-illustrate the use of the thrombolytic therapy protocol and illuminate its special indications and contraindications. Comprehensive and highly practical, Thrombolytic Therapy for Stroke offers the practicing physician everything necessary-background, protocols, and case studies-for the safe and effective treatment of the emergency stroke patient today


I Background and Basic Investigations -- 1 Mechanisms of Thrombolysis -- 2 Pathogenesis of Cervico-cranial Artery Occlusion -- 3 The Ischemic Penumbra and Neuronal Salvage -- II Scientific Rationale and Clinical Trials -- 4 Pre-Clinical Testing of Thrombolytic Therapy for Stroke -- 5 Combination of Thrombolytic Therapy with Neuroprotectants -- 6 Early Studies of Thrombolytic Therapy for Stroke -- 7 Phase 2 Experience with Intravenous Thrombolytic Therapy for Acute Ischemic Stroke -- 8 Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: Results of Large, Randomized Clinical Trials -- 9 Further Analysis of NINDS Study: Long-Term Outcome, Subgroups, and Cost Effectiveness -- 10 Intra-Arterial Thrombolysis in Acute Ischemic Stroke -- 11 Combinations of Intravenous and Intra-Arterial Thrombolysis -- III Using Thrombolysis for Acute Stroke -- 12 The Case for Thrombolytic Therapy in Stroke Patients -- 13 The Case Against the Present Guidelines for Stroke Thrombolysis: The Present Recommendations for Clinical Use Should Be Modified -- 14 How to Run a Code Stroke -- 15 Interpretation of CT Scans for Acute Stroke -- 16 Identifying and Overcoming Obstacles to Acute Stroke Treatment with rt-PA: Establishing Hospital and EMS Protocols -- 17 The NINDS t-PA for Acute Stroke Protocol -- 18 Research Directions and the Future of Stroke Therapy -- IV: Illustrative Cases

Medicine Neurology Medicine & Public Health Neurology


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