CT as the "Workhorse" in Helping Treat Stroke
The time-window for administering clot-busting drugs to stroke victims is generally considered to be within three hours after symptoms begin.1 But a recent editorial in the peer-reviewed medical journal Stroke suggests that perfusion computed tomography – a type of CT scan that measures blood flow through the brain – might expand that window to as much as nine hours.2 If so, CT would effectively expand the disability-reducing power of modern thrombolytic therapy, which has been shown to reduce both death and disability from stroke.
In an editorial entitled, "Reborn Workhorse, CT, Pulls the Wagon Toward Thrombolysis Beyond 3 Hours," Marrkku Kaste, MD, PhD, from Helsinki University Central Hospital, says that, while further study is needed, perfusion CT might be one avenue for enlarging the population whose lives could be saved or improved from thrombolytic therapy. Writes Kaste, "Modern perfusion CT technique could be one possibility for enlarging the target population, but it may also help exclude those who have nothing to gain from thrombolysis."
1 "Cost-Effectiveness of Tissue Plasminogen Activator for Acute Ischemic Stroke: NINDS rt-PA Stroke Study Group," Fagan SC, Morgenstern LB, Petitta A, Ward RE, Tilley BC, Marler JR, Levine SR, Broderick JP, Kwiatkowski TG, Frankel M, Brott TG, Walker MD, Neurology, Vol. 50, No. 4: 883-890: 1998.
2 "Reborn Workhorse, CT, Pulls the Wagon Toward Thrombolysis Beyond 3 Hours," Kaste M, Stroke, Vol 35: 357-359: 2004. Also see, "Prognostic Accuracy of Cerebral Blood Flow Measurement by Perfusion Computed Tomography, At the Time of Emergency Room Admission, in Acute Stroke Patients," Wintermark M, Reichhart M, Thiran J, Maeder P, Chalaron M, Schnyder P, Bogousslavsky J, Meuli R, Annals of Neurology, Vol. 51, No. 4: 417-432: 2002.
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