Stroke treatment: Beyond the three-hour window and in the pregnant patient

C. A. Cronin, C. J. Weisman, R. H. Llinas

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

For acute stroke patients who arrive at the hospital within 3 h of symptom onset, the focus of care involves screening for eligibility to receive intravenous tissue plasminogen activator. The publication of the National Institute of Neurological Disorders and Stroke recombinant tissue-type plasminogen activator (tPA, or alteplase) study in 1995 (Marler, J.R. 1995, New England Journal of Medicine 333: 1581-1587) spurred protocol changes, which continue to evolve, throughout the health care system in an effort to streamline the patient through the Emergency Medical System. The need to expedite patient evaluation involving emergency department, laboratory, radiology, and clinical neurology testing is clear and has been a focus of many stroke centers. For some patients, intravenous thrombolysis within 3 h has a dramatic effect on outcome. However, that is not the only course of action for acute stroke patients. This article will review some of the effective treatments for stroke patients beyond the first 3 h of their care.

Original languageEnglish (US)
Title of host publicationThe Year in Neurology 2008
PublisherBlackwell Publishing Inc.
Pages159-178
Number of pages20
ISBN (Print)9781573317306
DOIs
StatePublished - Oct 2008

Publication series

NameAnnals of the New York Academy of Sciences
Volume1142
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632

Keywords

  • Pregnancy
  • Stroke
  • Thrombolysis
  • Treatment

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

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