My correspondence regarding this article was published in Stroke a couple days ago. I’d like to say the author response is earth-shattering and insightful, but while it is not, they were kind enough to respectfully reply.
Sadly, the correspondence and response is available only to subscribers – but I have PDFs available for educational purposes….
“Letter by Radecki Regarding Article, ‘Safety of Thrombolysis in Stroke Mimics: Results From a Multicenter Cohort Study'”http://stroke.ahajournals.org/content/early/2013/08/08/STROKEAHA.113.002040.full.pdf+html
2 thoughts on “Letter in Stroke”
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Would like to see.
Fantastic. The concluding paragraph of the reply basically says that the benefits of treating early outweigh the harms of giving the drug to people who aren't having a stroke.
Now if we start from the premise that TPA is of no benefit in stroke then that is true. It will be no more useless in mimics (or colds or sore toes) and might even be better because at least those people don't have mushy, bleed susceptible brain lesions but I assume these folks aren't actually trying to say that TPA is not useful in stroke.
Dave Newman has given a lovely discussion of the "time is brain" assumption on his latest SmartEM podcast by the way.