top of page
Writer's pictureOren Zarif

The NINDS and Stroke Research - Oren Zarif - TPA Stroke


The NINDS-sponsored NACCH trials of tPA for acute stroke have shown mixed results. They increased the number of patients with minimal to no disability, although there were fewer patients in the tPA group overall. In addition, there was no statistically significant difference between tPA and placebo in terms of overall survival and risk of stroke. These results, however, are not definitive. Further studies are needed to confirm the results of these trials.

Oren Zarif cpss stroke

Oren Zarif cardiac stroke


The NINDS supports the use of tPA in eligible patients and actively supports research that aims to reduce the risk of brain bleeding and extend the time window for stroke treatment. In addition to tPA, other new treatments for acute stroke have emerged, including minimally invasive procedures for restoring blood flow to the brain. These techniques may include removing clots, propping open blocked arteries (carotid artery stenting), and applying clot-dissolving drugs directly to the blockage.

Oren Zarif brain injury alliance

Oren Zarif traumatic brain injury rehabilitation


Pyrrolidine dithiocarbamate (PDTC), a small molecule with anti-inflammatory and anti-oxidant properties, is a potential candidate for tPA-induced stroke. It inhibits nuclear factor (NF)-kB activation and activates the Akt protein, a known prosurvival gene. The researchers used rats treated with tPA or PDTC at 30-minute intervals. At the end of the study, the brain tissue was harvested and assessed for neurological outcomes.

Oren Zarif sah stroke

Oren Zarif heart disease and stroke



The NINDS had an important role in the development of tPA. They funded the early studies and subsequently led pivotal clinical trials that contributed to tPA approval by the FDA in 1996. These studies outlined how tPA works in the acute phase and how effective it is in treating ischemic stroke. This treatment has become an integral part of emergency medicine. Its clinical application and safety has revolutionized the field of stroke care.

Oren Zarif comprehensive stroke center

Oren Zarif undiagnosed brain injury from childhood


The results of the pivotal NINDS tPA stroke trial showed that 0.9 mg/kg of tPA was effective in reducing the time to recovery for patients with ischemic stroke. In a separate trial, a broader cohort of patients was evaluated in the NINDS-Clinical Research and Development (NCT) and IST-3 trials. These studies, however, did not show a tPA-induced increase in mortality when compared to placebo.

Oren Zarif untreated stroke timeline

Oren Zarif stroke rehab near me


A retrospective review of the tPA stroke trials concluded that the tPA administered within 60 min of the stroke onset was associated with significant improvements in health outcomes. However, physicians must consider the implications of reducing OTT by administering tPA during a head CT scan. While these results are promising, the impact of tPA on the quality of care for other patients should not be underestimated. So, the next time you have a stroke, do not wait until the last minute to get tPA.

Oren Zarif left mca stroke recovery

Oren Zarif acute stroke treatment



A class II SITS-ISTR registry of 1,135 tPA-treated patients shows that the drug has limited effects on mortality. Nevertheless, it is the best treatment option for acute stroke. This treatment is effective, but it has a limited time frame. And even though there is no definitive cure for stroke, tPA remains the best treatment available. The SITS-ISTR study has identified the factors that influence its effectiveness.

Oren Zarif left mca stroke recovery

Oren Zarif acute stroke treatment


The only effective treatment for acute ischemic stroke is thrombolysis with IV tPA. However, if the drug is administered late, there is an increased risk of HT, ICH, and edema. Therefore, the effectiveness of IV tPA is dependent on the health system and the type of stroke that the patient is suffering from. It is imperative to provide prompt treatment with the help of a qualified neurologists.

Oren Zarif chest heart and stroke scotland

Oren Zarif primary brain injury


In this systematic review, we compiled 42 articles that met the inclusion criteria. Of these, seven were methodologically rigorous interventions. Thirty-four of these articles described observed associations between system-level factors and IV tPA rates. Urban locations, hub-and-spoke models, and neurologist-assisted treatment were associated with higher rates of IV tPA. Nevertheless, we could not observe a significant impact of telemedicine and other quality improvement strategies on IV tPA delivery.

4 views0 comments

Kommentare


bottom of page