Why must a stroke be treated immediately?

The frequency of strokes in the United States is rising, with up to 800,000 strokes occurring every year. It's important to be able to recognize the signs of a stroke, because what happens in a stroke is that brain tissue dies. It's a race against time to get that addressed and get that treated: Some stroke treatments can only be used within a few hours after the stroke begins.

A weakness in one arm or one leg, a facial droop, loss of vision in one eye, loss of speech or slurred speech may indicate that you’re having a stroke. (Doctors use an acronym called FAST, which stands for face, arm, speech and time.)  The most important thing to do if you think you or a loved one is having a stroke is to call 911 and get to the hospital immediately. Don't wait around.

Dr. Jeffrey L. Saver, MD

The treatment for the most common type of stroke, ischemic stroke due to blockage of the blood vessel, is to give a drug that dissolves the blood clot and restores normal flow. However, restoring blood flow only helps if there is still brain tissue left to save. Nerve cells can tolerate reduced blood flow for only tens of minutesor a few hours. The clot busting drug is approved for use only up to three hours after symptoms start. Even within the first three hours, more brain can be saved the sooner treatment is started.

Time is of the essence in treating a stroke. Brain tissue that is starved of blood and oxygen, whether because of an ischemic or hemorrhagic stroke, may not yet be dead (infarcted)—offering a chance to limit brain damage. To deliver the best care, medical professionals first need to rule out other possible causes of your symptoms and then precisely diagnose the type of stroke that has occurred. Diagnosis, in turn, guides treatment and prevention strategies.

For example, an ischemic stroke caused by an embolus (a tiny fragment of a blood clot that formed on an atherosclerotic plaque) might be treated with a combination of medications including clot busters and anticoagulants, followed by preventive treatment to reduce blood pressure and improve cholesterol levels. But a hemorrhagic stroke caused by the rupture of a berry aneurysm may be treated with a combination of surgery to remove excess blood and reduce pressure on the brain, and an interarterial procedure, such as coiling, to prevent another rupture.

Dr. Steven A. Meyers, MD
Diagnostic Radiologist

During a stroke, blood flow to a region of the brain is interuppted and the brain cells begin to die. This process may be stopped or reversed if treatment is begun very quickly after the onset of the stroke.

A stroke occurs when the brain is suddenly deprived of blood and oxygen. With each passing minute, brain tissue dies. When brain tissue dies, disability and even death can occur.

Immediate medical care can stop stroke caused by a blockage in a blood vessel in the brain. Clot-busting drugs can be administered to open blockages, and treatments similar to those doctors use to open blocked arteries during a heart attack (balloon procedures and stents) can treat blockages in the brain to quickly restore blood flow and reduce the chance of disability or death. Additionally, if your stroke is caused by a bleeding, rather than blocked, blood vessel, doctors can work to stop the bleeding.

If too much time passes, unfortunately nothing can help.

It cannot be said too often: Call 911 immediately at the first sign of stroke.

Immediate treatment for a stroke is critical because brain cells die when they no longer receive oxygen and nutrients from the blood; further, they also are damaged by sudden bleeding into or around the brain. When blood flow to the brain is interrupted, some brain cells die immediately, while others remain at risk for dying.

If you experience the sudden onset of the worst headache in your life or a sudden onset of neurological symptoms, call 911 and get to a hospital immediately. Do not waste precious time by calling your healthcare professional and do not call a family member. This has been shown to cause unnecessary delays in treatment. The best action is to call 911.

The most effective therapies must be administered fast -- typically within three hours of when the stroke first started. Although some healthcare professionals suggest taking aspirin at the onset of a heart attack, it may not be the best home remedy for a stroke. Don't take aspirin in a stroke situation without advice of a healthcare professional.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.