ArticleThe Neurohospitalist2020
tPA for Acute Ischemic Stroke and Its Controversies: A Review.
Article in The Neurohospitalist, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- Co-Delivery of Sustained Release Chondroitinase ABC-37 With Human iPSC-Derived Neural Progenitors Promotes Transplant Survival and Functional Recovery in a Rodent Model of Stroke.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Critical ischemia duration thresholds in the rat middle cerebral artery occlusion model: Implications for drug screening.Neural regeneration research · 2026Article
- Assessing Outcome of tPA Therapy in Patients with Acute Ischemic Stroke (0-three hours).Pakistan journal of medical sciences · 2026Article
- Temporal Trends of Emergency Department Acute Ischemic Stroke Care in a Community Without an Academic Medical Center.Stroke · 2026Article
- Thrombolytic therapy in vertebrobasilar dolichoectasia patients with acute posterior circulation cerebral infarction: a case series analysis.Thrombosis journal · 2026Article
- Evolving FATE: A New Lens on the Pathogenesis and Management of Feline Cardiogenic Arterial Thromboembolism.Animals : an open access journal from MDPI · 2025Review
- The Role of Matrix Metalloproteinases in Hemorrhagic Transformation in the Treatment of Stroke with Tissue Plasminogen Activator.Journal of personalized medicine · 2023Review
- Neuroprotection of NADFrontiers in pharmacology · 2023Article
- Tissue plasminogen activator and patients with acute ischemic stroke: The litigation landscape.Journal of the American College of Emergency Physicians open · 2022Article
- Potential accuracy of prehospital NIHSS-based triage for selection of candidates for acute endovascular stroke therapy.Journal of the American College of Emergency Physicians open · 2021Article
- Salidroside Inhibits Reactive Astrogliosis and Glial Scar Formation in Late Cerebral Ischemia via the Akt/GSK-3β Pathway.Neurochemical research · 2021Article
- Thrombolytic Therapy DuringFrontiers in surgery · 2021Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAlthough neurologists consider intravenous tissue plasminogen activator (tPA) to be standard of care in the treatment of patients with acute ischemic stroke, its use remains contentious within the broader medical community, and particularly among emergency physicians. Why might this be? We provide a historical context to this ongoing controversy by reviewing how neurologists have conceptualized the acute stroke and its treatment, with the aim of bridging this gap.
methodsBased on historical sources in the Mackie Family History of Neuroscience Collection at the University of Calgary, as well as online resources, we trace the evolution of the concept of the "acute stroke," which has come to mean a stroke that is potentially treatable with tPA. We frame this conceptualization in relation to historical "building blocks" in anatomy, pathology, and physiology. We then use these building blocks to explain why neurologists understand tPA to be effective and why emergency physicians often do not. RESULTS AND
conclusionsArguments against the use of tPA reiterate 20-year-old concerns about its efficacy and safety. We believe these persistent concerns can be framed as a lack of understanding of the "building blocks" upon which neurologists' conception of tPA is built. Our view suggests that the way forward to bridge the gap between neurology and other disciplines is not to conduct more trials but to offer a shared conceptualization of the trials already completed and of the intellectual tradition from which they emerged.
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