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On the threshold of an exciting new era for acute stroke diagnosis
and treatment, the Third International Symposium on Thrombolytic
Therapy in Acute Ischemic Stroke was held in Nara, Japan, in April
1994. The symposium brought together some 200 basic and clinical
scientists for presentations and discussions of issues vital to the
understanding of thrombolytic therapy. This volume compiles the
major presentations of the symposium, with attention to
applications of new diagnostic measures such as diffusion and
perfusion MRI, contrast-enhanced transcranial Doppler and
angioscopy. Other presentations examine the mechanisms of
ischemia/reperfusion injury, hemorrhagic transformation, and
reocclusion, with reviews of recent developments in thrombolytic
agents. The proceedings of the symposium will be of special
interest to researchers, physicians, and students in the fields of
neurology, neurosurgery, and nuclear medicine, as well as those in
pharmacology, critical care medicine, and related fields.
Over the last decade, interest in treatment of ischemic stroke has
increased significantly. Perhaps the single most important feature
of attempts to improve the outcome of stroke patients has been that
the interventions be applied within the very early hours of stroke
symptoms. This has spawned efforts to understand the vascular and
neuronal responses to cerebral artery reperfusion experimentally.
Important prospective clinical studies of thrombolysis in acute
ischemic stroke have been completed, and large placebo-controlled,
symptom-based studies are now underway worldwide. Here, we consider
the central features of those studies, their experimental basis,
and the future importance of adjunctive therapies to recanalization
in focal brain ischemia acutely. Risks and benefits are discussed.
This collection benefits from the opinions of experts and workers
in this rapidly evolving and exciting field.
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