Stroke Symptoms and TPA

Patients who are worried about having a stroke  are becoming more sophisticated.
I have been asked by many about the “clot buster” medication also known as TPA, or thrombolytics.
And many people also know that they must arrive within 3 hours of stroke symptoms if they are going to be eligible for that treatment.
Well, a new study in the New England Journal of Medicine now suggests that the benefit seen in stroke patients given thrombolytics may be present up to 4.5 hours after stroke onset. Stroke specialists are still digesting this recent study, and are deciding what to do about it. Some stroke centers have already become early adopters of this new cut off, but others are taking a wait-and-see approach.
Unfortunately, even before this new study, stroke care in the United States was anything but streamlined, with widely varying capacity for stroke care among hospitals. Some hospitals are certified “stroke centers” and others are not. Some states have organized stroke systems, and others don’t. Add to that the relative disagreement among physicians about the utility and safety of thrombolytics in general, and I think patients are confused about what they should do.
The bottom line at this point is the following:
If you think you are having a stroke, call 911 right away. If you are a candidate for thrombolytics, the emergency physician or neurologist can explain the risks and benefits.
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