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May 22, 1995

The Future of Acute Stroke Treatment: Lessons We Have Learned From Laboratory and Clinical Research

Author Affiliations

Neurovascular Section Barrow Neurological Institute 222 W. Thomas Rd Suite 415 Phoenix, AZ 85013

Arch Intern Med. 1995;155(10):1005-1006. doi:10.1001/archinte.1995.00430100021002

A VARIETY of treatments have been tested in human trials for acute stroke.1,2 Many others have been studied in the laboratory.3 Although this work has yet to produce a proven effective treatment for acute stroke, it has generated important lessons that have brought us closer to solutions that may predict the future.

The most important lesson from the study of acute stroke treatment is that "time is brain."4,5 Treatments that have been effective in laboratory studies have often failed in human trials because the time to treatment was too great.6-13 Recognition of the "time limits for reversibility of brain ischemia"14,15 has led to human trials that now require treatment within 6 hours of symptom onset.16 The logical consequences of this should be more valid assessment of treatment efficacy and increased likelihood of success. The tissue plasminogen activator, streptokinase, heparinoid, N-methyl-D-aspartate receptor antagonist, free radical scavenger,