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Correspondence
October 2006

Nonstroke Treatment

Arch Neurol. 2006;63(10):1506. doi:10.1001/archneur.63.10.1506-a

The timely review1 regarding tissue plasminogen activator (tPA) use for acute stroke implies that some physicians' reluctance to prescribe tPA is attributable to their unjustified fear of cerebral hemorrhage for patients and litigation and poor pay for themselves. Because the reviewers' earnest premise is that tPA “increases recovery from stroke symptoms by up to 50% with a low serious complication rate,” they imply that choice should be certain. But a fourth factor to consider is that equally conscientious evaluation of the complex database by professional colleagues may be less enthusiastic.

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