Thrombolysis for patients with acute ischaemic stroke aged over 80

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.

Identifying blood biomarkers to improve the diagnosis of stroke

This review is based on Dr Whiteley’s Croom Lecture at the Trainees and Members’ Symposium on 22 October 2010.

Blood biomarkers are useful for the management of many diseases and could be useful for doctors caring for stroke patients, if they accurately predicted a diagnosis or recurrence of stroke. In a series of studies, we systematically reviewed the blood biomarker literature in stroke, determined the performance of existing blood biomarkers for the diagnosis of stroke and examined the value of markers of inflammation to predict recurrent stroke and myocardial infarction.

Multimodality imaging of exuberant mitral annular calcification in a patient presenting with transient ischaemic attack

We report an unusual case of calcification of mitral valve annulus imaged with multiple non-invasive modalities in a patient who suffered a transient ischaemic attack, probably from thrombus overlying the mitral annular calcification. Both this mode of presentation and the imaging features of the annular calcification were relatively unusual, and the images obtained are remarkably clear and diagnostic.

Keywords Anticoagulation, caseous mitral annular calcification, embolism, multimodality imaging, stroke, transient ischaemic attack