Deans' stroke musings: Small Step or Giant Leap? Expanding the Acute Stroke Thrombolysis Window to 24 Hours

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, June 15, 2024

Small Step or Giant Leap? Expanding the Acute Stroke Thrombolysis Window to 24 Hours

100% recovery is a giant leap, anything less is miniscule. The only goal in stroke is 100% recovery. Does this get us there?

Small Step or Giant Leap? Expanding the Acute Stroke Thrombolysis Window to 24 Hours

Author: Vivien H. Lee, M.D.Author Info & Affiliations

Published June 14, 2024

DOI: 10.1056/NEJMe2405846

Abstract

Intravenous tenecteplase has been shown to be noninferior to alteplase, with a meta-analysis suggesting superiority,¹ and although tenecteplase has been used off label, it is replacing alteplase as the preferred thrombolytic agent for the treatment of acute stroke. Aside from the use of thrombolysis for stroke on awakening (which applies to a limited population of patients with restrictive use involving the immediate need for magnetic resonance imaging to assess for mismatch between findings on diffusion-weighted imaging and those on fluid-attenuated inversion recovery imaging), thrombolysis for the treatment of acute stroke has generally remained confined to the 4.5-hour time window after . . .