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Clot-Busting Treatment Improves Bleeding Stroke Outcomes
Date:5/14/2008

Low dose tPA dissolved masses 2 to 3 times faster, dramatically boosting survival

WEDNESDAY, May 14 (HealthDay News) -- Researchers report they have dramatically increased the survival rate for people with strokes caused by bleeding within the brain by fine-tuning the dosage and timing for administering the clot-busting drug tissue plasminogen activator (tPA).

"We've gone from what's usually an 80 percent death rate in patients with this condition to an 80 percent survival rate," study leader Dr. Daniel Hanley, a professor of neurology at the Johns Hopkins University School of Medicine, said in a prepared statement.

This new treatment protocol for intracerebral hemorrhage (ICH) was developed through a multi-center study and reported this week at the European Stroke Conference, in Nice, France.

ICH causes blood to clot inside the brain's interior cavities, building up pressure within the brain. The higher pressure, along with inflammation caused by chemicals in the trapped blood, can irreversibly damage the brain, usually leading to death or extreme disability. No treatment existed for this until recently, Hanley said.

High doses (80 milligrams to 100 milligrams) of tPA have proven effective at breaking up clots in conditions such as heart attacks and other types of strokes, but there was concern that such levels of the drug may cause excessive bleeding in ICH patients. Previous studies showed that giving tPA to ICH patients hadn't significantly increased bleeding or death, so Hanley and his colleagues tested low doses to try to find the safest and most effective treatment regimen possible.

The researchers recruited 52 patients from across the United States, Canada, Great Britain and Germany who were recently diagnosed with ICH. Using the same catheter the patients had received inside the brain to release the trapped blood (the usual treatment for ICH), the researchers flooded tPA directly
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