A stroke is a brain injury that occurs when the brain is cut off from its blood supply. Getting the blood supply moving back into the brain is critical to keeping brain tissue alive and functioning. For years, doctors believed that this had to be done within six hours, or the damage done to the brain would be permanent.
As it turns out, they might have much more time, after all.
New research has shown that “While some brain tissue dies quickly after a stroke begins, in most patients, collateral blood vessels usually take over feeding a larger area of the brain that is also starved for blood and oxygen, giving doctors many more hours to save that tissue than they previously believed,” per the Washington Post. Instead of six hours, doctors may have as many as 16, or even 24 hours, in which to begin treatment. The study was so successful, the Post reports, that the researchers put an end to it early, so they could report their findings.
Fast facts about strokes
Strokes are classified three ways:
- An ischemic stroke is caused by an obstruction in the blood vessels (clot), and it is the most common type.
- Transient ischemic attacks are caused by temporary clots. They’re sometimes called “mini strokes.”
- Hemorrhagic strokes are the result of a ruptured blood vessel.
Strokes are responsible for approximately 140,000 deaths per year in the U.S., and is, overall, the fifth leading cause of death in the country. These percentages are mimicked in both Ohio and Kentucky. In 2014, the most recent year available, strokes were responsible for 2050 deaths in Kentucky, and 5791 deaths in Ohio.
What the research found
Before, doctors believed that they had a six-hour window in which to treat the clogged or ruptured blood vessels; longer than that, and the brain tissue would be irreparably harmed. If someone had a stroke right in front of another person, who could then call 911, the doctors could feel confident in that time slot. However, for those who had strokes in their sleep or while alone, there was no way to determine how much damage had been done. Even if the person’s life could be saved, there was no way of knowing whether he or she would suffer permanent brain damage.
However, for about half of all patients, the damage done by a stroke moves more slowly than it does for others. This means that doctors have a longer window to remove the clot, without fear of additional damage to the brain, per a Reuters reports.
Researchers “looked at 182 people in 38 medical centers who suffered the kinds of blockages in brain arteries that cause 50 to 60 percent of deaths and the most severe kinds of disabilities.” Around half of those people received the standard of care: medication and intervention; “The other half had images taken and the clot removal procedure, known as a ‘thrombectomy,’ as well as the medications.”
The imaging was the game-changer. It could show larger areas of damaged tissue, so doctors knew exactly how much tissue was dead, and how much was in danger. It also showed how the damage was progressing. Patients with slower progressions are good candidates for thrombectomies.
The results were extraordinary: 26% of the “control” group died, compared to only 14% of the group who had thrombectomies. Furthermore, 45% of the patients who had thrombectomies avoided severe disabilities and were able to “resume ‘functional independence.’”
Time is still critical in the diagnosis and treatment of strokes, but this new research could help doctors make better choices for their patients, and give patients a better chance at survival.
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