Thrombolysis for stroke [1]

Abstract

To the Editor. —The optimistic Editorial1 on thrombolysis in stroke emphasizes the need for rapid intervention: "time is brain." Two recent trials of thrombolytics have suggested a benefit for patients treated within 3 hours of stroke onset, while no benefit was found in trials in which treatment was instituted after 3 hours.1-4 On the basis of the National Institute of Neurological Disorders and Stroke (NINDS) trial,4 the Food and Drug Administration has approved tissue-type plasminogen activator (t-PA) to be labeled for use in stroke if used within 3 hours.3 But does this 3-hour criterion, relying exclusively on patients' or family members' recollections, delineate a well-defined group of ..