Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Stroke

Taking stock—patient selection for acute stroke therapy

To maximize the benefits of thrombolytic therapy at the population level, identifying which stroke patients are most likely to respond positively to this treatment is vital. The EPITHET Investigators propose specific diffusion-weighted and perfusion-weighted MRI lesion volume criteria that could be used for patient selection.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Parsons, M. W. et al. Pretreatment diffusion- and perfusion-MR lesion volumes have a crucial influence on clinical response to stroke thrombolysis. J. Cereb. Blood Flow Metab. doi:10.1038/jcbfm.2010.3.

  2. Davis, S. M. et al. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial. Lancet Neurol. 7, 299–309 (2008).

    Article  Google Scholar 

  3. Lansberg, M. G., Schrooten, M., Bluhmki, E., Thijs, V. N. & Saver, J. L. Treatment time-specific number needed to treat estimates for tissue plasminogen activator therapy in acute stroke based on shifts over the entire range of the modified Rankin Scale. Stroke 40, 2079–2084 (2009).

    Article  CAS  Google Scholar 

  4. Hacke, W. et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 363, 768–774 (2004).

    Article  Google Scholar 

  5. Breiman, L., Friedman, J., Stone, C. J. & Olshen, R. A. Classification and Regression Trees (CRC Press, Boca Raton, 1984).

    Google Scholar 

Download references

Acknowledgements

The author receives significant salary support from an NIH grant to develop strategies to select patients for acute stroke therapies.

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lansberg, M. Taking stock—patient selection for acute stroke therapy. Nat Rev Neurol 6, 358–359 (2010). https://doi.org/10.1038/nrneurol.2010.75

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneurol.2010.75

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing