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.”