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This week sees the official launch of a stroke thrombolysis trial at City Hospital in Birmingham led by Stirrer blogger and neurologist, Dr David Nicholl, who explains why there are still many more questions in stroke treatment that need answering.

There has been much publicity regarding stroke treatment in the media, with the FAST (Face, Arms, Speech, Time) test, to try and educate the public both of the symptoms of stroke, but also the importance to treat stroke as an emergency.

We should think of a stroke as a ‘brain attack’, just as we think of a heart attack as an emergency, and call ‘999’. This is vital, as modern treatments for stroke, such as clot busting thrombolysis drugs, are much effective if given quickly - within 3 hours of onset.

Although we know that thrombolysis is effective when given to patients with acute stroke when given quickly, there are still unanswered questions.

Is this type of treatment still effective in patients with a very mild or a very severe stroke, in those who present over 3 hours after onset or in patients over the age of 80?

We hope to answer these, and other questions, in the IST3 trial, which is the largest trial of thrombolysis in acute stroke. So far over 2000 patients have been recruited in this international study - there are 60 centres in the UK, six in the West Midlands, and this week City Hospital will be the latest addition.

Hopefully all the hard work will pay off (over a year of ethics and R&D applications), and the data from this study will help answer some of these questions for the treatment of acute stroke. So if you or your family are unfortunate enough to have a suspected stroke, get yourself to hospital fast.

Time literally is brain. Hopefully the data from trials such as IST3 will help us understand the best way to treat stroke in the future.



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