A Longer Treatment Window for Acute Stroke

In 2008 a group of European physicians published a study that argues that tPA is efficacious even if it is given up to 4.5 hours after the onset of acute stroke symptoms. Current standards established by older studies allow us to offer treatment for up to 3 hours after the onset of symptoms. Even though this might seem like a trivial difference in the time window of acute stroke treatment, it isn't at all. This precious 90 minutes have the potential to greatly increase the number of people who can benefit from acute stroke treatment.

Fewer than 10% of people who suffer acute ischemic strokes actually get treated, in large part because they arrive at the emergency department outside of the allowed 3 hour window. Treating after three hours has had no proven benefit, and it was thought it might actually be harmful due to an increased risk of bleeding in the brain. As physicians we are often frustrated when patients arrive in the emergency department with a stroke we can't treat for these reasons. But the results of this study give us great hope.

At this time we await further recommendations by the American Heart Association as to whether or not the conclusions of the study should or should not be implemented into clinical practice. I hope they can be.

Recommended reading:
Stroke Treatments
Stroke Symptoms
Blood Thinners and Their Side Effects