Of the similar findings between groups,"it is encouraging and it doesn't yet prove that they will get the same benefits, but it doesn't seem that the risk is excessive," said Dr. Steven Greenberg, vice chairman of the International Stroke Conference 2012's program committee and a professor of neurology at Harvard Medical School. "Even if only a subset of wake-up stroke patients were eligible for tPA, it is still a subset of a substantially large number, so the importance is pretty high."
The bottom line remains unchanged, he said: "If you or someone you know is having a stroke, call 911 or get to an emergency room as fast as possible. The earlier treatment is started within the 4.5-hour window, the better. With every minute that goes by, you lose part of the benefit and gain more risk."
"A large number of patients can't receive tPA is because they are too far past the window of opportunity," added Dr. M. Shazam Hussain, a neurologist at the Cleveland Clinic, in Ohio. Most "wake-up" strokes do occur close to when a person wakes up, he noted, so "potentially this will expand treatment quite significantly."
"A lot of people are denied treatment because there is no exact time of onset, because the risks may outweigh the benefits of tPA," he said. "I want to see a larger study done, but it certainly lends weight to help advocate for expanded use of tPA among wake-up stroke patients."
Find out about stroke warning signs at the American Stroke Association.
SOURCES: M. Shazam Hussain, M.D., neurologist, Cleveland Clinic, Ohio;
Steven Greenberg, M.D., Ph.D., professor, neurology, Harvard Medical School, Boston; Feb. 1, 2012, presentation, American Strok
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