[Thrombolysis]

About 65% of cerebral vascular accidents are due to occlusion of a large calibre artery, which spontaneously resolves during the hours or days following occlusion. Experimental studies have shown that neuronal death does not occur immediately. The hypothesis of thrombolysis is based on early restoration of cerebral blood flow by administration of a thrombolytic, which would facilitate neuronal recovery and reduce mortality and sequelae (efficacy hypothesis). Such early thrombolysis would not carry an excessive risk of symptomatic haemorrhage (safety hypothesis). The feasibility of thrombolysis in cerebral ischaemia is now established, but its efficacy and safety remain to be evaluated by randomised controlled clinical trials.