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The NINDS trial of Thrombolysis in Acute Ischaemic Stroke

Queen Elizabeth II Health Sciences Centre, Halifax, Canada, B3H 3T7. Email: ggubitz{at}is.dal.ca

EXTRACT

Neurologists are generally stepped in the time-honoured tradition of making meticulous observations about individual patients. Our occasionally obsessive tendencies allow us to fixate on the details of a patient’s history before performing a sophisticated physical examination, and (hopefully) arriving at a correct anatomical and pathological diagnosis for the particular problem. Recent technological advances have honed these diagnostic tools to an even finer edge. However, until fairly recently, the intellectual thrill of the neuro-diagnostic ‘chase’ went unmatched by the satisfaction of delivering effective treatment, leading to the ‘nice job but so what’ criticism often levelled at our speciality. To add a note of personal misgiving, the area within neurology that interests me most is stroke. I have lost track of the number of times that I have been told by other smug specialists, with a note of pity in their voices, that, ‘It’s all over as soon as the stroke has ...

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