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Medical News & Perspectives
September 18, 2013

Early Treatment of Ischemic Stroke With Intravenous tPA Reduces Disability Risk

JAMA. 2013;310(11):1111. doi:10.1001/jama.2013.278292

Very early treatment with intravenous thrombolysis for patients with mild-to-moderate acute ischemic strokes was associated with decreased risk of having permanent disability, according to a European study published August 22 in Stroke.

The American Heart Association/American Stroke Association (AHA/ASA) recommends getting patients to a hospital as soon as possible after onset of acute ischemic stroke symptoms for treatment with intravenous tissue-type plasminogen activator (tPA). This thrombolytic agent allows reperfusion of the brain and has proven benefit for select patients. AHA/ASA guidelines recommend giving tPA to treat stroke up to 4.5 hours after onset of symptoms. But sooner is far better than later because stroke rapidly causes irreversibly injured tissue, with 2 million additional neurons lost each minute until reperfusion is achieved.