Every second counts when treating a stroke

Jacqueline Carter, M.D., Neurologist, Medical Director of Columbia St. Mary's Stroke Centers

Posted: Sept. 1, 2006

While many people may survive a stroke, they are often left seriously disabled with significantly compromised skills for daily living.

Stroke onset symptoms include sudden numbness or weakness in the face or on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing; or sudden trouble walking or loss of balance.

A fast response for treating stroke has been proven to provide astounding results. When treatment is administered within a few hours after stroke symptoms appear, in many cases, we can almost completely reverse the effects of a stroke.

The clot-busting drug, tPA, not only helps patients survive a stroke, it can also lessen the severity of stroke complications. The critical factor to tPA, is that it must be administered within the first three hours after a stroke occurs. That’s why it’s so important for people to seek immediate medical care as soon as possible. It’s also recommended that the hospital is certified as a Stroke Center.

A certified stroke center is a medical facility that has been certified to meet certain criteria for treating stroke victims. Best practices, based on evidence proven through rigorous medical research, guide the patient’s care and treatment to produce the best outcome. For example, our nursing staff is trained to quickly assess patients for symptoms of stroke so that patients are guaranteed to see a physician within 10 minutes of their arrival to the emergency department A patient must undergo a CAT scan and receive the results within 45 minutes. In addition, a neurologist must be available for a telephone consultation within 15 minutes after being paged and arrive at the facility within 30 minutes for all patients who can receive tPA.

Upon arrival, the neurologist will physically assess the patient to determine whether he or she is a candidate for tPA. Besides the three-hour window, the neurologist must consider other factors to determine if tPA is the best option.

For example, before tPA can be administered, the neurologist must make sure the patient’s blood is able to clot. People who are taking certain types of blood thinners cannot be given tPA. Also, the stroke victim cannot have had major surgery or a heart attack within the previous three weeks or a lumbar puncture or angiogram the previous day.
If a patient is unable to speak, it is important a family member or friend be available to speak for the patient. That representative must also be knowledgeable about the patient’s recent medical history.

When a patient meets the criteria for receiving tPA, the drug is administered intravenously. The amount given is calculated according to the patient’s weight. Results are usually noticeable within 24 hours or sooner.

The drug tPA works by dissolving a “hole” in the clot, allowing blood to flow through the blockage. This new blood supply decreases the amount of damage to the brain and can often eliminate the effects of a stroke.

There are times when a patient may be administered tPA after the typical three-hour period has passed; however, it still must be given within six hours after the onset of symptoms. For these patients, the drug is injected directly into the blocked artery through a catheter.

In cases where tPA can not be used, the neurologist outlines the testing and treatment that a patient will need to enhance and hasten his recovery from stroke while minimizing the complications that can occur.

It is imperative to get help immediately if you suspect a stroke. Remember that every second counts in getting the expert treatment needed to maximize recovery and minimize damage.


Jacqueline Carter, M.D.
Neurologist, Medical Director of Columbia St. Mary’s Stroke Centers
(414) 291-1285

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