Every year, millions of people are treated for head injury. A substantial proportion die or are permanently disabled. The theory goes that aside from the direct damage at the time of the injury, the inflammation that follows leads to further problems. Fortunately, corticosteroids can reduce this inflammation so have been used to treat head injury for more than 30 years. This makes perfect sense, right?
Stories of Trials That Matter
This is streptokinase. It was first isolated from bacteria in the 1930s and in the lab was shown to breakdown blood clots (by converting plasminogen to plasmin). When a purified version became available in the 1950s there was great interest to find out if it might increase survival if given after a person had suffered a heart-attack. This resulted in the first randomised trials being undertaken at the end of the 1950s, so what did they show? If streptokinase was given after a person had a heart-attack was survival increased?