The trial was stopped early because of unacceptably high complication rates. If the trend toward a reduction in death and disability with therapy within three hours of stroke onset can be replicated in larger studies, thrombolysis may become a useful form of stroke therapy. If so, strategies such as public education programs may be needed to increase the number of patients presenting early after stroke onset. The beneficial results of the National Institute of Neurological Disorders and Stroke study and the encouraging data from the ASK Trial are but the beginning. The best thrombolytic agent, the appropriate dose, the preferred route, the best concomitant treatment, and the most suitable patients all remain to be worked out.
Prompt intervention holds the best hope for benefit.
The time has come for decisive and appropriate action against the leading cause of adult disability. Thrombolysis signals a milestone in the transformation of stroke from the realm of fatalism to a field of therapeutic opportunities. Read the abstract for this article or go back to the top. Unlikely Blunt trauma patients without vital signs have been considered a potentially enormous source of donor organs, but a study in the September issue of the AMA's Archives of Surgery finds the maximum yield would be only one donor per month. Factors that precluded donation included age, a prolonged interval between the injury and the declaration of death, a lack of timely availability of next of kin, refusal by next of kin, and the location of the injury.