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Stroke - help needed - easy question?

Jon Laake jon.laake at basalmed.uio.no
Wed Jun 7 04:28:05 EST 1995

In article <3r21ve$aa0 at nyx10.cs.du.edu>, anon1167 at nyx10.cs.du.edu (M) says:
>David, a brief reply to you question:
>Animal models have suggested that thrombolysis (dissolving the blood 
>clot) can reduce stroke injury with a time frame of something like 1-2 
>hours.  There is some concern that at longer post-ischemic intervals, 
>thrombolysis may be associated with hemorrhage, but his is 
>controversial.  Reperfusion of ischemic territory is obviously 
>desirable,, but under some circumstantces, can lead to additional damage, 
>noteably from whit blood cells.  There are experimental therapies to 
>reduce this reperfusion injury, however.  Thrombolysis is being tried in 
>human stroke patients and it appears promising; last winter a large 
>European trial showed a significnat improvement.  A large US trial is in 
>the analysis stage, I think.  
>You should be able to find many references in medline or whatever you 
The problem with thrombolysis is that one may open the blood-flow into a "graveyard"
of dead or dying nerve cells. Today we don't have any approved means of stopping the 
process initiated by the ischemic event which ultimately leads to the death of
the nerve cells. Simply turning on the blood flow with thrombolytics cannot solve this
basic problem, but very many different "neuroprotective" agents which are aimed
at blocking one of the many steps in the intracellular cascades leading to cell
death, are presently undergoing clinical evaluation. Admittedly thrombolytics seem 
to be of some marginal benefit. The problem is that patients need to be rushed to the
hospital with at least the same expediency as patients with heart attacks, preferably 
faster. In most places, neither the logistics of care nor the know-how of helath care 
providers or the general population is such as to make this feasible. We'll probably
get there though.

Jon Henrik Laake, MD
Dept. of Anatomy
Inst. of Basic Medical Sciences
Faculty of Medicine
University of Oslo
POBox 1105
0317 OSLO
Tel: +47 22851176 / 51150
Fax: +47 22851278
EMail: jon.laake at basalmed.uio.no

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