Time is critical when dealing with almost any medical condition, but this is especially true when faced with a stroke. The importance of timely access to appropriate treatment can be hard to comprehend, but this is simply because most of us don’t understand what a stroke is and how it affects the body. To truly grasp its importance, you first need to be aware of these facts.
A stroke is commonly described as a brain attack as the defining feature of a stroke is impaired blood flow to the brain. No matter the type of stroke, the supply of blood carrying oxygen and nutrients that are vital for brain function is obstructed and this damages brain tissue, causing brain cells to die within minutes. In fact, 1.9 million neurons are lost every minute from the time of a stroke.
Depending on the specific brain cells that are affected, the organs or bodily functions controlled by those brain cells will be affected. These effects can vary in severity or permanence, from temporary weakness in one side of the body, facial drooping, and loss of balance, to more lasting disability such as permanent paralysis on one side, memory loss, or speech impairment. The severity or extent of disability depends upon the speed with which treatment is provided.
In case of ischaemic strokes that involve blockage or reduced blood flow because of a clot, a medical therapy called thrombolysis can be administered. In this scenario, drugs like alteplase are introduced intravenously and they dissolve blood clots, helping restore blood flow to the brain. This type of treatment provides maximum benefits the sooner that it is started and if administered early enough may even prevent permanent brain damage and disability.
Unfortunately, this form of treatment is not viable after a period of 4.5 hours has passed since the onset of stroke symptoms. This is why this period is described as the ‘golden period’ of stroke treatment. Another emergency procedure called Thrombectomy may also be performed to remove blood clots that form obstruction in any large artery in the brain. This treatment is also effective only when started soon after a stroke.
When dealing with a haemorrhagic stroke, patients require emergency surgery to remove blood that accumulates in the brain and to repair burst blood vessels. This surgical procedure is termed as a craniotomy, during which a small section of the skull is removed in order to allow surgeons to repair damaged blood vessels and ensure that there is no further threat posed by blood clots that may still be present in the region. Once the bleeding is stopped and any clots removed, the removed section of the skull will be replaced, usually with an artificial metal plate.
When appropriate stroke treatment is not provided within the first 4.5 hours of a stroke onset, the treatment options are severely limited. Studies show that most treatments at this time have limited efficacy. Moreover, considering the rate at which brain cells are lost from the moment of a stroke (1.9 million neurons per minute), the longer that treatment is delayed, the more severe the extent of damage. This is why treatment delays are the main cause of high stroke mortality rates and permanent disability.
Here are some statistics that help to highlight the impact that delayed treatment can have on stroke outcomes. In India, 70% of stroke victims received delayed medical care – on average, 9.5 hours after the onset of symptoms. Not surprisingly, mortality and disability rates are high, with stroke recorded as the 4th leading cause of death in India and the 5th leading cause of disability.
