Word: strokings
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Breakthrough is a term that is overused in reporting about medicine. But the latest advances in stroke treatment--of which TPA is only the most dramatic--surely qualify for that term. Because stroke kills 150,000 Americans each year and is a leading cause of permanent disability, even a moderately effective treatment would make a profound difference in the quality of life of hundreds of thousands of people and their families...
...with TPA, or tissue plasminogen activator, have been nothing short of astonishing. The drug dissolves blood-vessel clots that block blood flow to the brain. "This is a particularly exciting time," says Dr. Mark Dyken, professor emeritus of neurology at Indiana University and the editor of the research journal Stroke. "In the past, most doctors thought of a stroke as the end, and that nothing could be done...
...addition to TPA, a series of advances in computer-imaging technology have enabled doctors to peer directly into the brain while a stroke is under way. The sharply detailed pictures reveal the type of stroke that is occurring, how far along the stroke has progressed and even whether various treatments are having an effect. Surgeons have also fine-tuned procedures in which they can perform preventive maintenance on some stroke-prone arteries. But the best is yet to come: researchers are developing medications that will actually protect portions of the brain from damage for as long as 12 hours after...
...this point that TPA has proved so effective. If given within three hours of the stroke's onset, the clot buster can interrupt the brain's panicked reaction. Damage may be kept so limited that it is imperceptible. Ideally, doctors would like to inject the drug within 90 minutes of the initial attack, underscoring once again the need for stroke suspects to get to an emergency room quickly...
Even then, TPA is not without risks. Because it thins the blood, it can also worsen a stroke by causing bleeding into the brain. "You can't know [in advance] which patient will have serious adverse effects," says Dr. John Marler of the National Institute of Neurological Disorders and Stroke, who headed the nih study of TPA. But some specialists believe the risk of bleeding from TPA is greater a couple of hours after the stroke. And they are adamant that the drug should never be used after three hours. Neurologists are now learning the subtle signs by which...