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Mild acute ischaemic stroke—the case for thrombolytic therapy

Nature Reviews Neurology volume 9, pages 653–656 (2013)Cite this article

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Abstract

The incidence of acute ischaemic stroke with mild neurological deficits (called mild ischaemic stroke [MIS]) is increasing, and studies show that a large percentage of untreated patients have poor long-term outcomes. Many physicians do not, however, routinely treat patients with MIS with intravenous recombinant tissue plasminogen activator (rtPA)—the only thrombolytic therapy currently approved by the FDA. Here, we discuss the reasons why physicians do not treat patients with MIS and we review the studies published to date regarding the potential risks and benefits of administering rtPA in this patient population. We then provide our perspective on why patients with MIS should be treated with intravenous rtPA and we highlight the need for a randomized clinical trial to address treatment of MIS.

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Acknowledgements

This work was supported by the SPOTRIAS P50 NS 044227 grant and the NIH Training Grant: 5 T32 NS0077412-12.

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Authors and Affiliations

  1. Department of Neurology, Stroke Program, University of Texas Medical School, 6431 Fannin, Houston, 77030, TX, USA

    Waldo R. Guerrero & Sean I. Savitz

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  1. Waldo R. Guerrero
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Contributions

W. R. Guerrero researched the data for the article. W. R. Guerrero and S. I. Savitz contributed equally to discussion of content, writing the article and review/editing of the manuscript before submission.

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Correspondence to Waldo R. Guerrero.

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The authors declare no competing financial interests.

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Guerrero, W., Savitz, S. Mild acute ischaemic stroke—the case for thrombolytic therapy. Nat Rev Neurol 9, 653–656 (2013). https://doi.org/10.1038/nrneurol.2013.174

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