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Early treatment confirmed as key to stroke recovery

A study in the March 6, 2004, issue of The Lancet* confirms the benefits of getting stroke patients to the hospital quickly for rapid thrombolytic treatment. The study provides the results of an extensive analysis of more than 2,700 stroke patients in six controlled clinical trials who were randomized for treatment with thrombolytic t-PA or a placebo.

While physicians have known since a breakthrough study in 1995 that early treatment with thrombolytics can improve a stroke patient's chance of a full recovery, only an estimated 2 to 5 percent of all eligible acute stroke patients in the U.S. are being treated with thrombolytics.

Stroke patients who were treated within 90 minutes of the onset of their symptoms showed the most improvement. The study suggests that t-PA given up to 4 hours after the onset of symptoms may be of benefit, but the authors caution that as time goes on there is a diminishing effect of treatment, and there is estimated to be almost no benefit when treatment is at 6 hours.

"Once again we learn that time is brain," said John R. Marler, M.D., one of the study authors and associate director for clinical trials at the National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH). "Although rapid stroke treatment presents a great challenge to physicians and may require substantial change in many health care systems, we now have stronger evidence that rapid early treatment offers the best chance of recovery for acute ischemic stroke patients."

Thrombolytics work as "clot busters," breaking up the clot that appears in the brain during an ischemic stroke, and allowing blood to flow freely again in the occluded or blocked artery. Patients must have computerized tomography (CT) scans of the brain taken before treatment begins to confirm that the stroke is caused by a clot. Seventy-five percent of patients who were treated within 60 minutes of stroke onset had the bes
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Contact: Marian Emr or Margo Warren
301-496-5924
NIH/National Institute of Neurological Disorders and Stroke
4-Mar-2004


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