Journal Mobile

G Ford, P Sandercock
Journal Issue: 
Volume 40: Issue 1: 2010




Stroke  is  the  major  cause  of  disability  in  the  community.  Most  strokes  are  due  to blocked arteries in the brain. Evidence is accumulating that clot-busting drugs improve outcome after ischaemic stroke. Recombinant tissue plasminogen activator (rt-PA) is licensed for the treatment of selected patients within three hours of acute ischaemic stroke in many parts of the world, and stroke services are being developed so that eligible  patients  can  receive  this  treatment  as  soon  as  possible  after  the  onset  of stroke symptoms. However, thrombolysis can cause bleeding into the brain, so the treatment should only be given when the benefits outweigh the risks. Controversy still  exists  about  the  risks  and  benefits  in  certain  groups  of  patients,  and  there  is variation in practice between stroke physicians, reflecting these uncertainties.

The  JRCPE  editorial  team  is  delighted  that  two  leading  experts  have  agreed  to debate the pros and cons of thrombolysis in people over the age of 80 years; one of the areas where there is still variation in practice. We hope that readers will find this debate enlightening, entertaining and informative.