Symptomatic ICH and outcomes in patients after IV tPA: A business of risk or risky business?

摘要

Since the earliest trials of IV thrombolysis (IV recom-binant tissue plasminogen activator [rtPA]) in acute stroke, the salient benefits of treatment have remained shadowed by an underlying concern for symptomatic intracerebral hemorrhage (sICH). Our current treatment guidelines stem from the sentinel prospective clinical trials in which sICH event frequency ranges from 2% to 8% depending on the definition.1"3 These rates of sICH are often quoted as static numbers, particularly in the setting of discussion with patients and families considering treatment, but most would admit that variations in actual risk for individuals likely occur.