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Stroke thrombolysis in the very elderly

Published online by Cambridge University Press:  20 September 2010

Cora McGreevy*
Affiliation:
Department of Geriatric Medicine, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland
Alan Moore
Affiliation:
Department of Geriatric Medicine, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland
Ciaran Donegan
Affiliation:
Department of Geriatric Medicine, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland
David JP Williams
Affiliation:
Department of Geriatric Medicine, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland
*
Address for correspondence: Dr Cora McGreevy, c/o Department of Geriatric Medicine, Beaumont Hospital, Dublin, Ireland. E-mail: coramcgreevy@eircom.net

Summary

Acute ischaemic stroke is common in older people and is associated with a higher morbidity and mortality compared with younger patients. Intravenous thrombolysis with recombinant tissue plasminogen activator (r-tPA) has become the mainstay of treatment and is the only evidence-based specific treatment for acute ischaemic stroke. However, little data are available on the safety of thrombolysis in the over-80 years age group due to under-representation of this group in trials and the upper age limit for licensing of the drug. In this review, we look at the pathophysiology of stroke and recent advances in neuroimaging techniques. We also look at the evidence base for use of thrombolysis in stroke and in particular analyse the trials that include the very elderly as subjects. Finally, issues around ongoing trials and future research are discussed.

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2010

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