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Mizuho interviews the Nerses Sannosian, the Neurologist who recommended tPA for Mizuho's 14 year-old. He explains that it was the best decision given what he knew at the time.
Dr. Sannosian, at about 7 minutes in, states the he believes he will harm 3 out of 100 patients to whom he gives tPA, but will help 32 out of 100. These numbers seem wildly optimistic given the literature, did he offer some justification for this view?
Thanks Zach for your comments. I will ask him and see what he says. Keep you posted.
I liked this interview and ultimately don't have a huge issue with the decision to thrombolyse, as it seems like it was an informed decision.
However, I would like to know what the literature says, if anything, about the natural history of strokes in young people in the pre-thrombolysis era. The plasticiity of their brains may be the exact reason NOT to thrombolyse them. Plus, we cannot know (as they acknowledge) what his outcome would have been without tPA.
Also, Dr. Sannosian seems to have made up some data. As far as I know the BEST DBRCT evidence we have, IF we ignore ALL the negative literature and only believe NINDS and ECASS 3, shows at best a likelihood to help:harm of 2:1. He suggests the this likelihood of helping versus harming is around 10. Not true.
What you do matters.