PET is Wonderful Annual Meeting 2020 Oct 27, 2020 02:00 PM - 05:40 PM — Virtual Meeting (online)
Through the Looking Glass: Breaking Barriers in STEM Oct 28, 2020 12:00 PM - 03:30 PM — Virtual Meeting (online)
NRS Mental Health Network Annual Scientific Meeting 2020 Nov 04, 2020 09:00 AM - 05:30 PM — Virtual Meeting (online)
Scottish Radiological Society Annual General Meeting 2020 Nov 06, 2020 09:30 AM - 03:30 PM — Virtual Meeting (online)
IPEM educational meeting: Artificial Intelligence in MRI Nov 18, 2020 12:00 AM — Virtual Meeting (online)


SINAPSE experts from around Scotland have developed ten online modules designed to explain medical imaging. They are freely available and are intended for non-specialists.

Edinburgh Imaging Academy at the University of Edinburgh offers the following online programmes through a virtual learning environment:

Neuroimaging for Research MSc/Dip/Cert

Imaging MSc/Dip/Cert

PET-MR Principles & Applications Cert

Applied Medical Image Analysis Cert

Online Short Courses

Alteplase and ischaemic stroke: have new reviews of old data helped?

Author(s): R. I. Lindley, J. M. Wardlaw, P. A. G. Sandercock

Background Thrombolysis for stroke is still not widely used as current recommendations restrict treatment to selected patients. In general, these are patients who can be assessed quickly by specialised stroke teams, have intracranial haemorrhage excluded by appropriate brain imaging, and are treated with alteplase (recombinant tissue plasminogen activator; rt-PA) within 3 h of symptom onset. There is, however, still much debate regarding the scope of treatment and the reorganisation of services required to support an effective service. Recent developments Two recent publications have helped clarify some issues. The first was an individual-patient data meta-analysis of the alteplase trials. These analyses suggest treatment effects beyond the usual 3 h time window, but other than time to treatment no other factors influenced the effects of treatment. The second publication was a reanalysis of the original National Institute of Neurological Disorders and Stroke (NINDS) alteplase trial, done after criticism of the original study. The reanalysis confirmed that there was significant baseline imbalance of stroke severity between treatment and control groups in the NINDS trial, but established that this did not materially affect the positive results of the trial. However, the recording of blood pressure in the study was found to be inconsistent and therefore unsuitable for reanalysis. The previously published data on recommendations for blood-pressure control, arising from the NINDS trial, needs to be reconsidered in this light. Both studies included too few patients to provide reliable data on which clinical and radiological features influence the response to alteplase. Where next? The individual-patient data meta-analysis and reanalysis of the NINDS trial have probably exhausted the potential of previous trials to answer questions on the effects of thrombolysis. Further randomised trials comparing thrombolysis with control will be required to determine whether elderly people benefit from treatment or whether there are worthwhile benefits from alteplase beyond 3 h (and in such patients, whether advanced magnetic resonance imaging is an effective way to select those most likely to benefit). Various new approaches to reperfusion. also require assessment in large-scale trials: new thrombolytic drugs, the combination of intravenous and intraarterial thrombolytic drugs, combinations of thrombolytics with new antiplatelet agents, and augmentation of thrombolysis either with mechanical devices or with transcranial ultrasound.

Full version: Available here

Click the link to go to an external website with the full version of the paper

ISBN: 1474-4422
Publication Year: 2005
Periodical: Lancet Neurology
Periodical Number: 4
Volume: 4
Pages: 249-253
Author Address: