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"Brain attack": an indication for thrombolysis?

S C Fagan1, B J Zarowitz, S Robert

  • 1Wayne State University, Detroit, MI 48202.

The Annals of Pharmacotherapy
|January 1, 1992
PubMed
Summary
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Thrombolytic therapy shows promise for acute ischemic stroke treatment, but carries a risk of hemorrhage. Early intervention within six hours is crucial for effectiveness, with ongoing trials to determine optimal use.

Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Acute ischemic stroke is a leading cause of disability.
  • Thrombolytic therapy offers a potential hyperacute treatment option.

Purpose of the Study:

  • To review the use of thrombolytics in acute ischemic stroke.
  • To emphasize supporting evidence and potential adverse effects.

Main Methods:

  • MEDLINE search for pertinent literature and reviews.
  • Selection of studies involving stroke patients and therapy toxicities.
  • Inclusion of ongoing clinical trial abstracts.

Main Results:

  • Animal studies support early thrombolysis (within 6 hours) for cerebral ischemia.
  • Thrombolysis appears safe in acute ischemic stroke models.

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  • Human data are largely anecdotal but suggest early thrombolysis is safe.

    • Conclusions:

    • Thrombolysis is a promising hyperacute stroke therapy, but intracerebral hemorrhage risk exists.
    • Timely treatment (within hours) is critical for efficacy.
    • Pharmacists must be knowledgeable about thrombolytic risks and monitoring; awaiting clinical trial results.