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tPa Clot-Busting

When a blood vessel in the brain becomes blocked, time is critical. Called a stroke, this blockage means part of the brain may not be getting the oxygen and nutrients it needs. If treatment is delayed, parts of the brain may die. Patients may then experience certain symptoms, such as slurred speech or the inability to move arms or legs. That means if a patient puts off going to the hospital when experiencing stroke symptoms, it could affect recovery.

Patients who don’t get to the hospital within 90 minutes of stroke symptoms starting may not be eligible to receive an effective “clot-busting” drug called tPA. tPA quickly dissolves the clots that cause many strokes. By opening a blocked blood vessel and restoring blood flow, tPA can reduce the amount of damage to the brain that can occur during a stroke.

“To be effective, tPA and other drugs like it must be given within a few hours of the stroke symptoms beginning,” explains Tessy Jenkins, M.D. “Because of this timeline, it is extremely important that patients who think they may be having a stroke go to the nearest emergency room immediately. A delay can mean they are not eligible for clot-dissolving drugs that can mean the difference between survival and death, or between complete recovery and severe disability.”

tPA benefits and risks

Clot-dissolving drugs are not for everyone and the stroke team at Sinai-Grace is trained to quickly identify those patients who are the best candidates.

Because tPA increases the risk of bleeding, patients who have a history of bleeding problems, recent surgery or trauma, uncontrolled high blood pressure or recent head injury may not be able to receive it. Some strokes are caused by a ruptured blood vessel, not a blocked blood vessel, so a CT scan is used to rule out these types of strokes.

“While the risks of tPA should be considered, the benefits of prompt treatment of the clot far outweigh the risks for most people,” Dr. Jenkins says. “If you or your family is faced with the decision to use tPA, listen carefully to the risks and benefits, but don’t delay your decision.”

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Symptoms of a Stroke

BE FAST is a good way to recognize the symptoms of a stroke, AND it’s a reminder to get help quickly. Every minute counts when it comes to having a better outcome and recovery from a stroke. Here’s how to recognize symptoms of a stroke for yourself or someone close to you:

B – Balance – Is there a loss of balance, coordination or trouble walking?
E – Eyes – Is it difficult to see in one or both eyes?

F – Face – When the person smiles, does one side of the face droop?
A – Arms – Does one arm drift down when the person raises both arms?
S – Speech – Is speech strange or slurred?
T – Time – Don’t wait to call 9-1-1 if you see any of the above signs.

Additional symptoms of a stroke include sudden:

  • Numbness or weakness, especially on one side of the body – face, arm or leg
  • Confusion in speech – understanding or speaking
  • Extreme headache – unknown cause

What Is a Stroke?

A stroke, also known as a brain attack, occurs when blood flow to the brain is interrupted or blocked. When this happens, brain cells in the immediate area start to die because they do not get the oxygen and nutrients they need to function properly. Disabilities that can result from a stroke include:

  • Paralysis
  • Cognitive or memory deficits
  • Speech and emotional problems
  • Pain and numbness

Approximately 87 percent of strokes are ischemic, which means they occur when a clot blocks a blood vessel or artery in the brain. The remaining percentage of strokes is hemorrhagic. These strokes are caused by a blood vessel that breaks and bleeds into the brain. In either case, the faster blood flow is restored to the brain, the lower the risk of disability or death. So the sooner a person gets to a hospital, the quicker the diagnosis and ability to prevent long-term damage.

Stroke Treatment

There is no home remedy for a stroke. It’s important not to wait for symptoms to go away or worsen. Ischemic strokes can be treated with a clot-busting drug called tissue plasminogen activator, or t-PA. However, for the treatment to be effective, the stroke patient must get to a hospital within one hour, be evaluated and receive the drug within three hours of the onset of stroke symptoms (or up to 4.5 hours for certain eligible patients). A study by the National Institute of Neurological Disorders and Stroke found that some patients receiving t-PA within the three-hour window were at least 30 percent more likely to recover from a stroke after 90 days.

Risk factors that can increase the chances of having a stroke include high blood pressure, heart disease, elevated cholesterol, diabetes, sedentary lifestyle and smoking. Knowing the symptoms of a stroke – and acting on them FAST – can save your life or the life of someone you care about.

Sources: https://www.strokeassociation.org/en/about-stroke/stroke-symptoms
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Stroke-Hope-Through-Research/Questions-Answers-Stroke