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Every Stroke Is Different. What That Means for Treatment

New research is offering hope for stroke patients who aren’t able to get medical treatment without the first six hours. (Getty Images)

When a person suffers a stroke, the swiftness of treatment can mean the difference between life and death or being able to function independently and suffering extensive disability.

As experts emphasize, time lost is brain lost. But for many who have a stroke, the life-changing event actually occurs when they’re asleep. That can mean precious hours are lost.

Treatment of ischemic stroke – the most common type of stroke, involving blockage of a blood vessel supplying blood to the brain – using clot-busting medicine, when appropriate, is now advised within the first four and a half hours after stroke onset. For patients who are candidates to have the clot mechanically or surgically removed, the procedure is generally recommended within the first six hours.

“So knowing that time frame is still very important, and it can help expedite treatment,” says Dr. Victor Urrutia, an associate professor of neurology and director of the Johns Hopkins Hospital Comprehensive Stroke Center in Baltimore. “The sooner you give the treatment, the better,” says Dr. Raul Nogueira, a professor of neurology, radiology and neurosurgery at Emory University School of Medicine and director of the neuroendovascular service at Grady Memorial Hospital in Atlanta. After the treatment windows pass, research has found these interventions don’t tend to benefit patients – who remain exposed to risks, like excess bleeding that can, like the stroke itself, be life-threatening

That makes it critical to call 911 and get emergency medical attention immediately when a person first notices common deficits, such as face drooping, arm weakness or speech difficulty, among other stroke signs highlighted by the American Heart Association and American Stroke Association. And it’s important to let clinicians know when those deficits first became apparent to help guide effective treatment. When a person has a stroke, they experience a sudden deficit, or difficulties doing certain things, explains Dr. Robert Brown, chair of the division of stroke and cerebrovascular disease and professor of neurology at Mayo Clinic in Rochester, Minnesota. And, of course, these symptoms vary. “At the onset of a stroke, people will have the abrupt onset of weakness in the face, arm or leg – oftentimes in combination – difficulty speaking, difficulty understanding others, difficulty with vision, difficulty with gait, difficulty with sensation, [or] numbness,” Brown says.

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