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Updated: Aug 12, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Stroke: killer clots and killer drugs
1University of Edinburgh, Edinburgh, UK. cpw@skull.dcn.ed.ac.uk
Therapeutic thrombolysis is an immense opportunity in acute stroke care. For the first time, there is a treatment that has a high probability of being effective if given early enough to patients with acute ischemic stroke. However, the risks of intracranial hemorrhage are substantial and as yet the exact indications and contraindications have not been worked out. And indeed how to deliver this treatment in routine clinical practice. As stroke units proliferate and become more organized, and physicians become more specialized in stroke care, it will become easier both to further assess in randomized trials and to deliver thrombolysis, certainly intravenously and maybe in some centers intra-arterially in suitable cases.
Therapeutic thrombolysis is an immense opportunity in acute stroke care. For the first time, there is a treatment that has a high probability of being effective if given early enough to patients with acute ischemic stroke. However, the risks of intracranial hemorrhage are substantial and as yet the exact indications and contraindications have not been worked out. And indeed how to deliver this treatment in routine clinical practice. As stroke units proliferate and become more organized, and physicians become more specialized in stroke care, it will become easier both to further assess in randomized trials and to deliver thrombolysis, certainly intravenously and maybe in some centers intra-arterially in suitable cases.
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