May 9th, 2011
05:27 PM ET
Patients who suffer severe strokes often get a clot-busting treatment – one that must be delivered within just a few hours.
But a new study released in Neurology estimates that some 58,000 patients go to the emergency department every year in the United States after waking up with the symptoms of a stroke.
In those cases, nobody really knows when the stroke began, so doctors do not prescribe the most common treatment for ischemic strokes (those caused by clots, as opposed to a brain bleed) – a medication called tissue plasminogen activator (tPA).
That’s because after a few hours the risk of hurting a patient outweighs the potential of helping with the treatment.
Ischemic strokes, caused by clots blocking blood from flowing to the brain, make up the vast majority of strokes.
The study author hopes that one day other techniques will reveal when a stroke began.
“Imaging studies are being conducted now to help us develop better methods to identify which people are most likely to benefit from the treatment, even if symptoms started during the night,” said study author Dr. Jason Mackey of the University of Cincinnati.
But those imaging techniques are still in development.
Researchers found that 98 of the 273 wake-up strokes used in their study would have qualified for the clot-busting treatment if medical staff could only have known when the stroke symptoms began.
The study also found people with wake-up strokes to be, on average, slightly older – 72 years of age versus 70 years of age for strokes beginning while awake.
Wake-up stokes were also slightly more severe on average than non-wake-up strokes.
Signs of stroke include sudden numbness in the face or limbs, and sudden difficulty with speech and understanding.
“People think stroke symptoms will go away,” says Mackey. “It’s important to emphasize that 911 be called immediately.”
This study used information about 1,854 ischemic strokes presenting to an emergency department in the Greater Cincinnati region.
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