International Circulation: For Reverse Robin Hood Syndrome， in terms of therapeutic targets how significant is this for future stroke therapeutics?
　　Dr Alexandrov: Breathing problems during sleep or sleep apnea is very common for stroke patients and as well as stroke reoccurrence， heart attacks and sudden death. Furthermore， their diabetes is worse and their blood pressure control is suboptimal.  Therefore identifying these patients early in order to prevent stroke is a promising area of research. But what stroke clinicians and internal medical clinicians need to be aware of immediately is that if they suspect obstructive sleep apnea， they have to refer the stroke patient after discharge to a formal sleep study because this is one of the factors which is neglected in stroke studies.
　　International Circulation: You are involved with the Clotbust trial. Please summarize the rationale and the endpoints you expect?
　　Dr Alexandrov: Our collaborative group is launching a phase three trial and aiming to determine if we are changing functional recovery at three months. This by combining TPA with ultrasound， our endpoint is modified ranking score 0-1， which is independent of complete recovery at three months.
　　International Circulation: You published an article regarding stroke mimics， What are these?
　　Dr Alexandrov: Our ability to diagnose stroke depends on imaging and MRI is a close as it gets to a gold standard. But MRI can sometimes be unattainable during the early moments of stroke.  And so in the emergency room you have to decide to give TPA based on clinical evaluation and a normal CAT scan. This could be normal if you have ischemia and normal if you do not have ischemia. Stroke mimics are conditions which can produce stroke like presentations.  These range from seizures to complicated migraines.  We have always wanted to know if we misdiagnose stoke but not for bleeding but for other benign causes， if we do CPA would it be safe.  It turns out that misdiagnosis is uncommon but if it occurs it is safe because there is no bleeding.