Challenge of Stroke Thrombolysis & Thrombectomy

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1 Jul 2016 - General

Stroke Medicine has advanced for the last few years. Stroke (Ischaemic) patient, within the onset time of less than 4.5 hours, are the candidate for thrombolysis, plus minus thrombectomy, based on criteria of the branch occlusion, and ASPECTS score.  Both NINDS stroke trial and ECASS 3 trial, showed that stroke thombolysis is potentially beneficial up to 4.5 hours from the time of onset. Immediate, concise history taking and physical examination, with prompt CT-Brain (+/- CT-A), are required to reduce the door-to-needle time for stroke thrombolysis. And time is the limting factor in stroke thrombolysis, if the onset time is more then 4.5 hours. Please share and discuss any challenges or difficulty you face in managing FAST postive, stroke thrombolysis case ???.