Thrombolytic therapy in acute ischaemic stroke: the jury needs more evidence

Randomised controlled trials have shown that thrombolytic therapy for acute ischaemic stroke may reduce the rate of death and disability at three- or six-month follow-up, but may also increase the risk of haemorrhage and early death. Probable predictors of increased risk are severe neurological deficit and early signs of infarction on computed tomography, but these remain to be confirmed. More research is needed to determine which stroke patients will benefit from thrombolysis and the best regimen to use.