The Duke study shows that half of those brought to stroke centers arrive within three hours of symptom onset, said Dr. Brian Silver, an assistant professor of neurology at Wayne State University who practices at Henry Ford Hospital, both in Detroit. "If you expanded the tPA window, you could go to 50 percent being treated," said Silver, a spokesman for the ASA/AHA.
But it is not clear whether other medical organizations will support an expanded window for tPA therapy, and the most important issue is getting people to hospitals for treatment quicker, since brain damage increases steadily with time, Silver said.
"We want to get patients treated as early as possible," he said.
"We need to educate the public, as well as family members of people at risk of stroke, so that they will be aware of the symptoms and respond quickly," Goldstein said.
The warning signs of stroke include sudden weakness of the face, arm or leg, especially on one side of the body; sudden confusion and difficulty in speaking; sudden trouble in seeing; sudden dizziness or loss of balance and sudden severe headache.
It's not possible to tell if arrival times have changed since 2004, the last year for which information on stroke treatment is available, Lichtman said. "What this study shows us is how important it is to monitor trends over time, to see how well we are doing on the patient front and on the system front," she said.
With a better sense of those trends, "we can focus on improving care and outcome," she added.
Stroke symptoms and what to do about them are described by the American Heart Association.
SOURCES: Larry B. Goldstein, M.D., professor, neur
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