Stroke Treatment Plagued by Missed Opportunities

The New York Times (5/28) reports that "from diagnosis to treatment to rehabilitation to preventing it altogether, a stroke is a litany of missed opportunities."

Many doctors are "...reluctant to give the only drug shown to make a real difference, tPA, or tissue plasminogen activator," because a significant number of "patients with stroke symptoms are examined by emergency room doctors who are uncomfortable deciding whether the patient is really having a stroke...or is suffering from another condition."

Although tPA "was shown in 1996 to save lives and prevent brain damage, and although the drug could help half of all stroke patients, only 3 percent to 4 percent receive it. Most patients, denying or failing to appreciate their symptoms, wait too long to seek help -- tPA must be given within three hours. And even when patients call 911 promptly, most hospitals, often uncertain about stroke diagnoses, do not provide the drug."

In addition to these impediments, many "hospitals say they cannot afford to have neurologists on call to diagnose strokes, and cannot afford to have MRI scanners, the most accurate way to diagnose strokes, for the emergency room."