With a stroke, there’s a limited amount of time doctors can give emergency clot-dissolving treatment. “We’ve known that six hours after their stroke onset, that was kind of the time window we were looking for,” says Dr. Richard Williamson, a neurosurgeon at Allegheny General Hospital. The problem is, when someone wakes up with stroke symptoms, the clock actually starts at when the person went to bed. In many cases, it’s too late to do anything besides customary care, which includes blood thinners and blood pressure medications. “If patients presented after that six hour time window, our hands were somewhat tied,” Dr. Williamson adds. A new study supports a treatment that can be done up to 16 hours after the onset of stroke symptoms. A stroke is when a portion of the brain goes without blood flow and the tissue dies. Stroke symptoms can include numbness or weakness on one side of the body, loss of vision, double vision, slurred speech, loss of speech or understanding, dizziness, balance problems. It all depends on which part of the brain is affected. Strokes are often caused by clots in a brain vessel. Doctors now think other nearby vessels help to maintain some blood supply before the tissue is completely dead, which gives them time to do something called a thrombectomy, or removal of the clot. “We go up through all the arteries in the body, up into the blockage in the artery in the brain,” Williamson said. The doctor then uses special instruments to suck the clot out of the brain. The study included 182 people at medical centers across the country with strokes associated with the most disability because of the vessels involved. Half got typical care, the other half had a thrombectomy and medications. Twenty-six percent of the usual care group died, compared to 14 percent of the thrombectomy group. Almost half of the patients in the thrombectomy group were able to function independently afterward. Special CT scans were used to determine the ratio of damaged brain to brain at risk. “Once it reaches a certain threshold, we know we have good reason to intervene,” Williamson said. This is only available at comprehensive stroke centers, but will be covered by insurance. “I think it’s absolutely going to change what we consider standard,” Williamson said. “If it’s within 16 hours, we should treat it like it just happened.” Source
