The window of stroke care

Time saved is brain saved when it comes to stroke patients

Time saved is brain saved when it comes to stroke care.

“Stroke is one of the leading causes of death in the U.S,” said Shervin R. Dashti, M.D., Ph.D., endovascular neurosurgeon and spine surgeon at Norton Neuroscience Institute. “Three-quarters of a million strokes per year, many million stroke survivors, and it’s one of the leading causes of adult disability. And of the patients who survive stroke, 90% will have some type of deficit.”

In a recent continuing medical education (CME) presentation, Dr. Dashti discussed the time window of care for stroke patients and what can be done to improve outcomes for stroke patients.

What is the window of stroke care?

“For every minute that passes after an ischemic stroke, millions of neurons and billions of synapses are damaged,” Dr. Dashti said. “We find that medical treatment with IV tPA has the best outcomes if administered within 4 1/2 hours of the ‘last know well’ or stroke symptom onset.”

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Patients who fail or are ineligible for medical treatment can often be treated by mechanical thrombectomy, which involves threading a small catheter through the artery in the patient’s wrist, all the way in the arteries of the brain to remove the clot that is blocking blood flow and causing the stroke.

“The window of treatment for mechanical thrombectomy is up to 24 hours of last known well,” Dr. Dashti said.

Medical and interventional treatments for stroke

“Medical treatment uses medicines to address the condition. For ischemic stroke we use IV tPA, an intravenous clot-busting medication, to break up clots that block flow into the blood vessels in the brain. IV tPA is the gold standard of medical stroke care,” Dr. Dashti said. “Interventional treatments are procedures like the mechanical thrombectomy.”

“Restoring blood flow to the brain via mechanical thrombectomy, if done in a timely manner, can potentially prevent disabling strokes and even death.”

Post-stroke care

Initial care after a stroke is critical, and post-stroke care is equally important.

“The sooner that any necessary therapies are started, the better: These include physical therapy, occupational therapy, and speech therapy.  With all of these treatments and interventions, the goal is to mitigate the impact a stroke has on a patient’s life. We want the patients to return to their loved ones and live fulfilling lives,” Dr. Dashti said.

View Dr. Dashti’s CME presentation in its entirety:


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