Journal scan.

Thrombolysis for acute ischaemic stroke Thrombolysis for acute ischaemic stroke remains a controversial area. The National Institute of Neurological Disorders and Stroke study (NINDS) trial reported improved long term neurological function when patients were treated with intravenous tissue type plasminogen activator (iv tPA) within three hours of symptom onset. This benefit was set against an increased risk of intracerebral haemorrhage (ICH). Further studies have produced similar results, although others have not shown any benefit. Doubts remain regarding the safety and eYcacy in routine clinical use outside specialist centres. The debate continues in this contentious area and two contrasting papers show diVerent positions and results. It would be a useful postgraduate educational exercise to compare and contrast these studies in detail and try to explain the very diVerent findings in these trials. What are the main conclusions that you draw from this issue? Prize for the best critique that is e-mailed to the Journal scan editor by 22 September 2000.