Echoplanar Imaging Thrombolysis Evaluation Trial (EPITHET)
Echoplanar Imaging Thrombolysis Evaluation Trial (EPITHET)
To determine whether the extent of the ischemic penumbra apparent on perfusion-diffusion MRI
 can be used to identify patients who would respond positively and safely to tissue
 plasminogen activator (tPA) beyond 3 hours post-stroke.
Inclusion Criteria:

 -  Patients who present:

 -  with acute hemispheric stroke within 3-6 hours of onset,

 -  have at least moderate limb weakness,

 -  a National Institute of Health Stroke Scale (NIHSS) score > 4,

 -  had a pre-stroke modified Rankin Scale (MRS) score of 0 - 2

 -  and who are able to undergo CT and MRI, are eligible for this study.

 Exclusion Criteria:

 -  Females who are pregnant or breast-feeding,

 -  persons who have CT-verified hemorrhagic stroke, major ischemia ( > 33% of the middle
 cerebral artery (MCA) territory infarcted), subarachnoid hemorrhage, arteriovenous
 malformation, aneurysm, intracranial neoplasm that is terminal or poses a risk of
 hemorrhage ,

 -  are comatose or severely obtunded with fixed eye deviation and complete hemiplegia,

 -  have had another stroke within the past 6 weeks,

 -  have had a seizure prior to the administration of the study drug,

 -  have active peptic ulceration, bleeding diatheses, previous intracerebral hemorrhage,

 -  blood pressure > 185/110,

 -  major surgery or trauma within the past 30 days, or any other contraindications to tPA

 -  have a presumed septic embolus or a myocardial infarction within the past 30 days

 -  blood glucose values are < 2.8 or > 22.0 mmol/L,

 -  pacemakers, aneurysm clips, implanted devices, claustrophobia, or any other
 contraindications to MRI,

 -  decreased consciousness,

 -  rapid clinical improvement,

 -  confounding neurological condition (e.g. dementia),

 -  any other life-threatening illness, or who are participating in another clinical
 trial, will be excluded from this study.