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Surgical Delivery of Drug Shows Promise Against 'Bleeding' Stroke
Date:2/7/2013

THURSDAY, Feb. 7 (HealthDay News) -- Stroke patients who had surgery to deliver the powerful clot-busting drug tPA directly into the brain had better and quicker recovery than those who received standard treatment, a small new study finds.

The researchers looked at 96 patients, aged 18 to 80, who suffered an intracerebral hemorrhage, a type of stroke caused when a blood vessel ruptures in the brain.

According to the team from Johns Hopkins University School of Medicine, in Baltimore, intracerebral hemorrhage has long been considered surgically untreatable in most cases. About 50 percent of people with this type of stroke die. It is much less common than ischemic stroke, which is caused by a clot in a blood vessel in the brain.

One expert not connected to the study said that although people with a stroke caused by a clot often get the clot-busting drug tPA (tissue plasminogen activator), that's not the case for less common bleeding strokes.

"Historically, patients with bleeds into their brain were either observed or underwent cranial surgery to remove the clot and alleviate the intracranial pressure," said Dr. David Langer, director of cerebrovascular research at North Shore University Hospital in Manhasset, N.Y. "Clot-busting drugs were not utilized for fear of aggravating the problem by potentially causing more bleeding."

In the new study, however, some of the patients underwent surgery to deliver tPA directly into the golf-ball-sized blood clots in their brain. For this procedure, doctors drilled a dime-sized hole in the patient's skull, placed a catheter in the hole and then guided it to the clot. Small doses of tPA were dripped through the catheter for several days.

Another group of patients received more standard therapy, which essentially gives clots a chance to shrink on their own.

The researchers reported that blood clots shrank by about 20 percent a day for the patients who got tPA and
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