A GLIMPSE TO THE FUTURE - MULTITHERAPY TRIALS

Multi-modality therapy for acute ischaemic stroke is an emerging conce pt stimulated by the existing vacuum in stroke treatment and an increa sing understanding of the ischaemic cascade. Experimental studies have shown that infarct size can be reduced more by combinations of reperf usion and neuroprotective strategies than by either one alone. An opti mal combination regimen remains to be determined, but will probably ta rget several sequential events occurring after ischaemia. Many logisti c hurdles must be overcome before multimodality therapy can be properl y tested in clinical trials. This will require a combination of pragma tism, adherence to scientific principles, and international cooperatio n among clinic investigators.