n South African Medical Journal - South African ischaemic stroke guideline, 2010 : correspondence

Volume 101, Issue 1
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



We believe the guideline by Bryer et al. to be overdue and well constructed, and generally to contain excellent recommendations. However, the authors note that intravenous tissue plasminogen activator (tPA) 'is an accepted therapy' and 'significantly improves outcome'; particular reference is made to the ECASS III trial to justify its use within 4.5 hours of stroke onset. We believe that this is a dangerous and unsupported recommendation.

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