Why is thrombolysis for stroke not used as often as for heart attack?
The problem of thrombolysis in stroke is slightly complex. To be effective, it has to be given within three hours. Stroke has to be confirmed by CT scan and bleeding excluded. If the stroke is massive, there is a risk of bleeding into the infarct with thrombolysis. Another problem is that within 3 hours, it is difficult to differentiate a small stroke from a transient ischemic attack (TIA). All said and done, if the stroke is not too massive, thrombolysis is quite useful if given within 3 hours. More public education is needed for this to effective. Most often people seek medical advice quickly in a heart attack, but not in stroke (brain attack), or at least in milder strokes.