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After a Stroke, Time is Critical, Even More Than Previously Thought

  • Carol Pearson

After a large vessel stroke, a new study finds that a shorter time to treatment after a stroke is critical to having the best recovery.

Stroke is the second leading cause of death worldwide and the third leading cause of disability according to the World Health Organization.

Researchers from the University of California, Los Angeles, wanted to find out what window of time could provide the best recovery rate for stroke patients, along with which treatment also worked best. So they reviewed outcomes of more than 1,200 patients experiencing acute ischemic stroke — a stoke in a major artery that cuts off the blood supply to the brain.

Some patients received standard clot-breaking medicine and others received that plus a thrombectomy, a procedure using a tool that pulls clots out of an artery.

Their findings: the sooner the patient had a thrombectomy, the better the overall recovery.

"Time makes a big difference. Every four minutes that goes by after a patient gets to the hospital, one fewer out of 100 patients has a good outcome if the artery hasn’t been opened,” says Dr. Jeffrey Saver, director of the Comprehensive Stroke Center at the University of California Los Angeles, also known as UCLA.

Blood clots in major arteries cause blood to stop flowing to the brain, and without a blood supply, the brain cells begin to die, which is why time is of the essence when treating a stroke.

“If you get the artery open at three hours, then 65 percent of patients will be able to live independently three months later. If it takes eight hours to get it open, then only 45 percent will be able to live independently. It makes a major difference in outcome,” said Saver.

Saver said it is critical for everyone to know the signs of stroke — facial drooping, arm weakness and difficulty with speech. When these symptoms appear, it's critical to get emergency care.

"Often the patient can't make the call themselves because the stroke is affecting their speaking or their ability to recognize they are having a stroke," he said.

The study was published in JAMA, The Journal of the American Medical Association. Some researchers say the study may change the treatment stroke patients receive when they first come into the hospital.

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