ABSTRACT
Stroke is a major cause of serious, long-term disability and the third leading cause of death, accounting for one in every 18 deaths in the United States. Approximately 800,000 strokes occur in the United States each year, leading to an estimated cost of 74 billion dollars in 2010 (1). The majority of these events are ischemic (87%), as opposed to intracerebral (10%) and subarachnoid hemorrhages (3%) (1). Management of acute ischemic stroke was previously geared toward prevention, supportive care, and rehabilitation. Over the past few decades, however, the medical management of stroke has progressed exponentially, beginning with the US Food and Drug Administration (FDA) approval of tissue plasminogen activator (r-tPA, alteplase) in 1996. Intravenous administration of r-tPA within a limited 3-hour window from symptom onset has shown a significant improvement in patient outcome at 3 months and at one year following an acute cerebrovascular event (2).
