This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (55)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Thrombolysis  • Neurology  • Cerebrovascular Disease  • Cardiovascular System  • Cardiovascular Intervention  • Alert me on articles by topic  Social Bookmarking   What's this?

Marc Fisher, MD; Julien Bogousslavsky, MD

JAMA. 1998;279:1298-1303.

The effective treatment of acute ischemic stroke remains an important goal of modern medicine and substantive advances are occurring. Recently, thrombolytic therapy with tissue-type plasminogen activator was approved for selected patients with acute ischemic stroke when therapy is started within 3 hours of onset. Streptokinase therapy for acute ischemic stroke has not been shown to be effective and is associated with an increased risk of hemorrhage, although it was not evaluated as early after stroke onset as tissue-type plasminogen activator. Various types of neuroprotective interventions are effective in animal models, but none has yet been proven effective in patients. In the future, combinations of thrombolytic and neuroprotective drugs may be used to attempt maximum rates of recovery after acute ischemic stroke. For combination therapy to achieve its maximum potential, patients with acute ischemic stroke will have to be carefully selected and treated.

From the Department of Neurology, Memorial Health Care, University of Massachusetts Medical School, Worcester (Dr Fisher); and Department of Neurology, University of Lausanne, Lausanne, Switzerland (Dr Bogousslavsky).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Stroke Treatment: Promising but Still Struggling
Louis R. Caplan
JAMA. 1998;279(16):1304-1306.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Neurochemical Characterization of a Neuroprotective Compound from Parawixia bistriata Spider Venom That Inhibits Synaptosomal Uptake of GABA and Glycine
Beleboni et al.
Mol. Pharmacol. 2006;69:1998-2006.
ABSTRACT | FULL TEXT  

Combination Therapy in Ischemic Stroke: Synergistic Neuroprotective Effects of Memantine and Clenbuterol
Culmsee et al.
Stroke 2004;35:1197-1202.
ABSTRACT | FULL TEXT  

Recommendations for Advancing Development of Acute Stroke Therapies: Stroke Therapy Academic Industry Roundtable 3
Fisher
Stroke 2003;34:1539-1546.
ABSTRACT | FULL TEXT  

CT-Based Assessment of Acute Stroke: CT, CT Angiography, and Xenon-Enhanced CT Cerebral Blood Flow
Kilpatrick et al.
Stroke 2001;32:2543-2549.
ABSTRACT | FULL TEXT  

SB 239063, a Second-Generation p38 Mitogen-Activated Protein Kinase Inhibitor, Reduces Brain Injury and Neurological Deficits in Cerebral Focal Ischemia
Barone et al.
J. Pharmacol. Exp. Ther. 2001;296:312-321.
ABSTRACT | FULL TEXT  

Combined Intraarterial/Intravenous Thrombolysis for Acute Ischemic Stroke
Keris et al.
Am. J. Neuroradiol. 2001;22:352-358.
ABSTRACT | FULL TEXT  

Treatment of Acute Ischemic Stroke
Brott and Bogousslavsky
NEJM 2000;343:710-722.
FULL TEXT  

Stroke Treatment Economic Model (STEM) : Predicting Long-Term Costs From Functional Status
Caro and Huybrechts
Stroke 1999;30:2574-2579.
ABSTRACT | FULL TEXT  

Recent progress in drug treatment for acute stroke
DEVUYST and BOGOUSSLAVSKY
J. Neurol. Neurosurg. Psychiatry 1999;67:420-425.
FULL TEXT  

Combination Drug Therapy and Mild Hypothermia : A Promising Treatment Strategy for Reversible, Focal Cerebral Ischemia • Editorial Comment: A Promising Treatment Strategy for Reversible, Focal Cerebral Ischemia
Schmid-Elsaesser et al.
Stroke 1999;30 :e1891-1899.
ABSTRACT | FULL TEXT  

Old Problems, New Techniques: The Interventional Radiologist and the Lacrimal Apparatus
Weissman
Radiology 1999;212:305-306.
FULL TEXT  

Consensus in stroke management?
Bogousslavsky
BMJ 1999;318:140-141.
FULL TEXT  

Stroke Treatment: Promising but Still Struggling
Caplan
JAMA 1998;279:1304-1306.
FULL TEXT