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The golden three hour tPA window for stroke treatment

By April 15, 2008

Researchers in the 1990s came up with tissue plasminogen activator, otherwise known as tPA, for the treatment of ischemic stroke. Over 80% of all strokes are of this type, and are commonly caused by blood clots that interrupt blood flow in an area of the brain. tPA acts by dissolving these stroke-causing blood clots. Its efficacy has been proven by several large clinical trials which show a greater chance of recovery in stroke patients who are treated with it. However, these trials also show that, if given later than three hours after a person first realizes he/she is having stroke symptoms, tPA can cause dangerous bleeding in the brain. Consequently, it is only safe to give tPA within 3 hours of the beginning of stroke symptoms, which is why physicians think of this time as the "golden three hour tPA window".

Unfortunately, the 3 hour window is often missed due to delays in treatment generated both by the patient, and by the medical system. Because of this only a small fraction of stroke patients receives tPA.

Perhaps the most common cause of delay in getting tPA is the lack of awareness about stroke signs and symptoms by the general public. Most people wait up to a day after their symptoms start before seeking medical attention because they simply don't know their symptoms are those of a stroke. Many organizations are now working to correct this knowledge gap so that many more people affected by stroke can benefit from tPA. You can help get this much needed treatment to those who one day might need it by educating them before they are ever affected by a stroke. If you know the signs and symptoms of stroke, teach them to your parents, your children and other people around you. This simple act of kindness might one day make a major difference in their lives if they ever suffer a stroke.

Recommended reading:
What are the symptoms of a stroke?
The best hospitals for stroke treatment
Acute stroke teams and the timely delivery of tPA

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