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Should you have a Neurology/Stroke related professional resource that you would like to display, please contact GNYMASCC with the details at the email listed below.


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High Blood Pressure: It May Be Riskier Than You Think

Know Stroke. Know the Signs. Act in Time.
 & Spanish 

Stroke Risk Factors and Symptoms
English & Spanish 

What You Need to Know About Stroke

English & Spanish 

Know Stroke Information Card

Stroke: Challenges, Progress, and Promise

Stroke: Hope Through Research
 & Spanish 

Post-Stroke Rehabilitation
 & Spanish 

Brain Basics: Preventing Stroke

English & Spanish 

Clinical Practice Guidelines for Stroke

Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association


Guidelines for the Management of Spontaneous Intracerebral Hemorrhage


Guidelines for Adult Stroke Rehabilitation and Recovery


Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient


Benefits of tPA for Stroke Extended  to 9 Hours Post Onset

Like mechanical revascularization, IV thrombolysis with a pharmacologic agent can help preserve the functional capabilities of patients even 4.5 to 9 hours after stroke onset -- provided they still have salvageable brain tissue, published data from the EXTEND trial showed.


People who presented late but with imaging results showing relatively small infarct cores still had better odds of good functional outcomes after getting alteplase, as 35.4% of this group scored a 0 or a 1 on the modified Rankin scale (mRS) at 90 days, compared with 29.5% of the placebo arm (adjusted RR 1.44, 95% CI 1.01-2.06), reported Geoffrey Donnan, MD, of Royal Melbourne Hospital, and colleagues in the New England Journal of

Medicine. The trial randomized 225 stroke patients who had arrived at the hospital later than the first 4.5 hours after symptom onset or after waking up with a stroke. They were imaged with CT perfusion imaging and perfusion-diffusion MRI.

Main results from EXTEND were first presented in February at the American Heart Association's International Stroke Conference.

Yet a secondary ordinal analysis of the distribution of mRS scores did not show better functional improvement at 90 days with late thrombolysis, according to the full New England Journal paper, which also came with an accompanying editorial.


In addition, the risk of symptomatic intracerebral hemorrhage was increased with alteplase (6.2% vs 0.9%, adjusted RR 7.22, 95% CI 0.97-53.5).

"The authors are to be commended for a groundbreaking trial. It suggests, for the first time, that the benefit of alteplase may persist after more than 4.5 hours of symptoms in selected patients," Pooja Khatri, MD, MSc, of the University of Cincinnati, told MedPage Today.

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