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Special Stroke Test May Help More People
Jan. 24, 2002 -- Researchers from Australia say doctors can identify more stroke victims who may benefit from clot-busting drugs, even after the accepted three-hour treatment window has gone by.
Today, clot busters are given only to people who get to the emergency room within three hours of noticing stroke symptoms, which include numbness or weakness in an arm, leg, or face; slurred speech; or memory lapses.
There is not enough proof that using clot busters more than three hours after a stroke is helpful. After that point, the risks of bleeding in the brain may outweigh the potential benefits.
But senior researcher Stephen M. Davis, MD, and colleagues at Royal Melbourne Hospital in Australia have shown that in some situations, clot busters are good for the brain up to six hours after noticing stroke symptoms, providing doctors have tested which patients would respond well to the treatment. Their study appears in the January issue of Annals of Neurology.
They studied 16 people with a stroke caused by a clot in the brain. They used a special MRI technique to determine which areas of the brain had already been killed by the stroke and which areas could potentially be revitalized with clot busters.
Each of the 16 people received the clot buster -- called tPA -- an average of four hours after noticing stroke symptoms. For some people, however, six hours had elapsed. Their results were compared to 16 people with strokes who did not get tPA treatment.
The clot buster was able to dissolve the clot significantly and return blood flow to the areas of the brain that were damaged but not yet dead. Those who received the clot buster recovered more brain function than those who did not get this treatment.
Doctors aren't likely to start using clot busters more than three hours after a stroke starts. But this study will spur more research into how long after a stroke is too long to give clot busters, as well as which methods are best in trying to figure out how much of the brain still can be saved.
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