Timing Is Key In Stroke Treatment

With Drugs Like tPA And Bat Venom, Quick Action Is Vital

(CBS)  More than 750,000 people suffer strokes each year. Strokes are the third-leading cause of death behind heart disease and cancer — and the leading neurological cause of long-term disability. While the incidence of strokes in the U.S. over the past 50 years has declined, their severity has not.

During a stroke, 2 million brain cells die every minute. That's why doctors at Harlem Hospital are conducting a drill with a volunteer — to decrease the time it takes to treat future stroke patients, CBS News medical correspondent Dr. Jon LaPook reports.

When a stroke occurs, blood flow to a region of the brain is blocked. A drug known as tPA can limit the damage for an estimated one in three patients.

"It goes directly to the area that is blocked and dissolves it," says Dr. Olajide Williams — sort of like a Roto-Rooter.

But using tPA requires speed and special expertise. It must be administered within the first three hours of a stroke, and only after doctors have determined that there is no bleeding. Giving this powerful drug during bleeding can be fatal.

The problem is getting the drug to patients within the three-hour limit, and there are only about 300 stroke centers, like Harlem Hospital, with specialists in tPA. But thanks to the Internet, it's now possible for doctors at more hospitals to beat the clock with tPA.

When Evelyn Roy was rushed to her local hospital in Cape Cod with stroke symptoms, Dr. Lee Schwamm at Massachusetts General's stroke center in Boston was able to evaluate her over the Internet and instruct the local doctors to give her tPA.

"It was a miracle," Roy says.

"Cracking that three-hour barrier is so important because the length of time for patients to recognize their symptoms, get to the hospital and get the full evaluation they need," Schwamm says.

There's also hope for patients like 46-year-old Jeff Porter, who don't get treated in time for tPA.

"I couldn't really communicate. I couldn't verbalize anything," Porter says.

Schwamm gave Porter a new drug, made from the saliva of vampire bats, which is being tested in patients who get it three to seven hours after a stroke.

"The bat venom is like a heat-seeking missile that goes right for the blood clot in the brain and ignores the blood clots in the rest of body," Schwamm says.

"I started to feel better, and then by the next day I started to stand and walk around," Porter says.

The hope is that drugs like these, combined with fast work by physicians and increased patient recognition of symptoms, will help save even more lives.

[unclephred]

"When a stroke occurs, blood flow to a region of the brain is blocked. snip "

NONONONONONONONO!! That IS true for the most common kind of STROKE, but NOTNOTNOT true for 20% of all strokes, the difference can be deadly, treatment for one kind of stroke,(block)could KILL folks suffering from the other (Bleed) kind of stroke! I'm very greatful this subject is being discussed, but please do not leave out how very little can, or is being done for that other 20%.
fvp

[latheena]

Investigational Study for Stroke Recovery

If you have suffered a stroke and have weakness in one hand as a result, you may be eligible to participate in an investigational study to evaluate the safety and effectiveness of an implanted device* in treating patients who have reduced hand and/or arm function after stroke. Patients must be at least 21 years old and the stroke must have occurred at least four months ago. For more information, contact 888-546-9779.

* Caution: Investigational device. Limited by Federal (or United States) law to investigational use.

[sfj5]

Thank you for highlighting the new treatments available for acute stroke patients. Much work needs to be done to get the word out about symptom recognition and then to get patients to the hospital immediately. I am the stroke coordinator for a community hospital and it saddens me when a patinet arrives too late for the new therapies for stroke. I must say though that for the patinets I have witnessed receiving t-PA the results have been miraculous!
Susan Jenkins, MS,APRN-BC
Stroke Coordinator
Charlton Memorial Hospital
Fall River, MA