To the Editor: In their analysis of data from
the National Institute of Neurological Disorders and Stroke (NINDS) study
of recombinant tissue plasminogen activator (rt-PA), Dr Patel and colleagues1 found that early ischemic changes (EICs) on computed
tomography (CT) within 3 hours of stroke onset are correlated with later severity
of stroke, but that EIC is not helpful in determining which patients would
benefit from rt-PA. Patel et al also found a relatively low rate of EICs.
In contrast with the ECASS II cohort,2 where
the frequency of EIC was 58% for the first hour, 66% for the second, and 65%
for the third, Patel et al found EICs in only 31% of their patients. Other
studies also found higher incidence rates for EIC within 3 hours of stroke
onset.3,4 Explanations for
this discrepancy may include technical reasons as well as different definitions
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 3
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.