Clinical Recovery from Acute Ischemic Stroke after Early Reperfusion of the Brain with Intravenous Thrombolysis

Abstract

To the Editor: A 1995 study found that treatment with tissue plasminogen activator (t-PA) was efficacious for intravenous thrombolysis if given within three hours after the onset of ischemic stroke.1 The drug most likely improves the outcome by inducing early reperfusion of ischemic but not infarcted brain tissue.2,3 The earlier t-PA is given, the better the chance of clinical improvement and a good outcome.4 We describe a case in which early intravenous treatment with t-PA, monitored noninvasively by transcranial Doppler ultrasonography, produced dramatic clinical improvement. While at work, an 85-year-old right-handed woman suddenly became mute and weak on her . . .