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Project: Ghana Emergency Medicine Collaborative
Document Title: Stroke Management in the 21st Century: What Do You
Need to Know?
Author(s): Rashmi Kothari (Michigan State University), MD 2012
License: Unless otherwise noted, this material is made available under the
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We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability
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Reference: Tissue Plasminogen Activator for Acute Ischemic Stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group5
N Engl J Med 1995; 333:1581-1588. http://www.nejm.org/doi/full/10.1056/NEJM199512143332401.
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Facial Droop
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Normal:
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St Bartholomew's Hospital Archives &
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Normal:
Abnormal:

Both sides of face move equally
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Arm Drift
Both arms move equally or not at all
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Speech
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12
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14
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20

Placebo

rt-PA

31
0

10

20

30

Number of Patients
((N Engl J Med 1995:333)

40

30
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Mortality

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17

5

10

15

20

25

Number of Patients
(N Engl J Med 1995:333)

31
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Percentage of t-PA Patients with Symptomatic ICH
18
16
14
12
10
8
6
4
2
0

17

2
0-5

3
6-10

5

4

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Baseline NIH Stroke Scale Score
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32
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Placebo
n=312
n=312
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(mean days +SD)

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Home

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112(36%)

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91 (29%)

115 (37%)

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39 (13%)

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40 (13%)

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* compared home to all other dispositions

33
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34
R*5%&>3l(%$F.+(M.&035*/($2+3*4/$
Study

Time to
Treat
228 <4 hrs

MAST-I

622 <6 hrs

Mortality

SK+ASA

NA

43%

NA

22%

SK

18%

35%

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MAST-E 270 <6 hrs

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ASA

ASK

N

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18%

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10%

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ASA

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10%

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35

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