The Most Important Stroke Treatment is Time

“Time is Brain” is a memorable catchphrase that explains why it is so important for people experiencing symptoms of a stroke to receive prompt care.

Dr. Ram Chavali

We are in a time and place where a little education can make anyone a hero.

“Time is Brain” is a memorable catchphrase that explains why it is so important for people experiencing symptoms of a stroke to receive prompt care. A stroke occurs when a blood vessel in the brain is either blocked or bursts.

In the first case, when a blood clot blocks a major blood vessel in the brain, it is immediately affected. And the longer the brain is deprived of oxygen-rich blood, the greater the chances of long-term disability and even death.

While advances in stroke treatment continue to be developed, the most important action is still calling 911 right away.

Types of Strokes and Treatment Options
It’s important to know when the stroke happened because as time goes on, the treatment options become more limited. People who get medical attention early enough can receive medications and treatments to limit a stroke’s impact, or even save their life.

After arriving at the hospital, doctors will order a a special X-ray called a CT scan of the brain to determine the type of stroke the person suffered.

If it is a hemorrhagic stroke—a stroke caused by a blood vessel in the brain bursting–treatment focuses on stopping the bleeding.

For an ischemic stroke—a stroke caused by a blood clot blocking a vessel that supplies blood to the brain—treatment involves either busting the clot or physically removing it.

For many patients, the blood clot can be treated with clot-dissolving medication called tissue plasminogen activator, or tPA. This medication needs to be given within 3 hours of having a stroke, or for some eligible patients, up to 4 ½ hours after the onset of a stroke.

But in a stroke caused by larger blood clots, a special procedure called mechanical thrombectomy may be needed.

Mechanical Thrombectomy
Mechanical thrombectomy is an advanced procedure used to remove large blood clots from the brain. Specially trained doctors use a catheter inserted through an artery in the groin to send a wire-caged device called a stent retriever to the site of the blocked vessel in the brain. The stent opens up and grabs the clot, allowing doctors to remove it. This procedure should be done within six hours of the onset of a stroke.

Patients near hospitals like Lancaster General Hospital, that offer mechanical thrombectomy, can get important, timely care without having to be transported far away from their homes. And because time truly is brain, this provides the greatest chance for complete recovery.

About 800,000 Americans suffer a stroke each year. While people with large clots make up a small percentage of that number, they are at greatest risk for disability and death.

Stroke Symptoms
Stroke symptoms happen quickly and can include:

• Numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body
• Vision changes
• Trouble speaking
• Confusion or trouble understanding simple statements
• Problems with walking or balance
• A sudden, severe headache that is different from past headaches and often described as the “worst headache of my life” (may be related to a hemorrhagic stroke)

If you or someone you are with experiences any of these symptoms, call 911 immediately.

Medical treatments like tPA and mechanical thrombectomy are making a huge difference in both survival rates and quality of life for stroke patients. But the effectiveness of any stroke treatment depends on getting the right care as quickly as possible. Call 911 if you experience any symptoms of stroke.

Ram Chavali, MD, is medical director of endovascular stroke intervention at Penn Medicine Lancaster General Health and Lancaster Radiology Associates, Ltd.

Dr. Chavali has extensive experience in interventional neuroradiology and acute stroke care.