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Antiplatelet Therapy and the Risk of Intracranial Hemorrhage After Intravenous Tissue Plasminogen Activator Therapy for Acute Ischemic Stroke
Hen Hallevi, MD;
James C. Grotta, MD
Arch Neurol. 2008;65(5):575-576.
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Intravenous administration of tissue plasminogen activator (tPA) is currently the only approved therapy for acute ischemic stroke. The drug works by splitting plasminogen into plasmin, ultimately leading to fibrin degradation at the site of cerebral artery occlusion. Even today, more than 10 years after the drug was approved in the United States (and subsequently around the world), its use has been hampered by the fear of inducing symptomatic intracerebral hemorrhage (SICH). This adverse event was seen in 6% of patients treated in the original National Institute of Neurological Disorders and Stroke trial1 that led to tPA's approval and was subsequently confirmed in multiple postmarketing studies.2-3 The predictors of SICH after tPA administration are well known: severe stroke (high National Institute of Health Stroke Scale score) and large hypodensity on the admission computed tomography. Other possible predictors include advanced age, elevated blood glucose, a . . . [Full Text of this Article]AUTHOR INFORMATION
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