Intravenous delivery of an approved clot-busting drug remains the most beneficial proven intervention for ischemic stroke, according to American Heart Association.//
The Guidelines for the Early Management of Adults with Ischemic Stroke also indicate that new options – such as intra-arterial administration of clot-busting drugs and mechanical removal of blood clots – show promise.
The guidelines focus on the crucial first hours from the time an ischemic stroke occurs through emergency evaluation and treatment in a hospital. Ischemic strokes, the most common type of stroke, are caused by a clot that blocks blood flow in an artery to the brain.
The panel emphasized the importance of public education on the symptoms of stroke, which include:
? Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
? Sudden confusion, trouble speaking or understanding
? Sudden trouble seeing in one or both eyes
? Sudden trouble walking, dizziness, loss of balance or coordination
? Sudden, severe headache with no known cause
Patients or observers should call 9-1-1 when stroke symptoms first develop.
"We are pushing for the fastest possible treatment because 'time is brain.' For every minute that goes by, the likelihood of a poorer outcome increases," said Harold P. Adams, Jr., M.D., chairman of the writing group.
Intravenous delivery of the clot-busting drug tissue plasminogen activator (tPA) is only approved to be used within three hours of symptom onset.
The panel said other techniques – mechanical devices and intra-arterial administration (IA) of tPA – are becoming more widely available and should be considered for patients with moderate-to-severe strokes who arrive at the hospital too late to receive intravenous tPA. However, information on these techniques is limited and more research is needed.
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