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Improved Outcomes In Stroke Thrombolysis With Pre-Specified Imaging Criteria, B. Silver, B. Demaerschalk, J. G. Merino, E. Wong, A. Tamayo, A. Devasenapathy, C. O'Callaghan, A. Kertesz, G. B. Young, A. J. Fox, J. D. Spence, V. Hachinski
Improved Outcomes In Stroke Thrombolysis With Pre-Specified Imaging Criteria, B. Silver, B. Demaerschalk, J. G. Merino, E. Wong, A. Tamayo, A. Devasenapathy, C. O'Callaghan, A. Kertesz, G. B. Young, A. J. Fox, J. D. Spence, V. Hachinski
Department of Medicine Publications
Background: A 1995 National Institute of Neurological Disorders (NINDS) study found benefit for intravenous tissue plasminogen activator (tPA) in acute ischemic stroke (AIS). The symptomatic intracranial hemorrhage (SICH) rate in the NINDS study was 6.4%, which may be deterring some physicians from using this medication. Methods: Starting December 1, 1998, patients with AIS in London, Ontario were treated according to NINDS criteria with one major exception; those with approximately greater than one-third involvement of the idealized middle cerebral artery (MCA) territory on neuroimaging were excluded from treatment. The method used to estimate involvement of one-third MCA territory involvement bears the …