Thrombolytic therapy for stroke

Stroke is a common condition affecting approximately 110,000 people every year in England alone. It is the third leading cause of death and the single largest cause of adult physical disability [1]. A third of individuals who have a stroke are left with a long-term disability that may include weakness, sensory impairment and loss of cognitive and communication skills, depending on the regions of the brain affected. Stroke currently costs the National Health Service and the UK economy GB£7 billion per year – GB£2.8 billion in direct healthcare costs, GB£2.4 billion of informal care costs and GB£1.8 billion in income lost to productivity and disability [1]. Stroke has been defined as a rapid onset of focal neurological deficit with objective evidence of cerebral damage, with no apparent cause other than disruption of blood supply to the brain [2]. This clinical definition includes both hemorrhage and infarction and, although still robust, has been refined by the increasing use of neuroimaging in recent years. Early brain scanning is needed to distinguish other pathology that may mimic stroke, exclude hemorrhage (especially if thrombolysis is being considered) and to provide information on the type and location of stroke, all of which may influence early management decisions [3].