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Time is Brain: Why It’s Important to Get Treated for Stroke ASAP

Knowing the telltale signs of a stroke is critical to getting immediate medical attention. Read on to understand what happens during a stroke and lifesaving treatment options.

Editor’s note: This article was updated from an earlier version posted in June 2021.

If you or a loved one has ever had a stroke, you may be familiar with the phrase time is brain—meaning time is of the essence when treating a stroke. With each moment that a stroke goes untreated, the nervous tissue in the brain is rapidly and irreversibly damaged. That is why it’s important to seek immediate medical attention if you or someone you know begins to experience stroke symptoms.

Here, neurosurgeons Dr. Robert Rosenwasser and Dr. Stavropoula Tjoumakaris discuss what you need to know about why time is the most important treatment for stroke and how Jefferson Health is working to make it easier for stroke patients to be treated quickly.

What Happens During a Stroke

If someone is having a stroke, it means there’s a lack of blood flow to the brain, which deprives brain cells of oxygen. For every minute that passes while someone is having a stroke, 1.9 million brain cells are lost. The longer that someone is suffering from a stroke, the greater their chance of disability or death.

“The sooner you get to us, the greater your chance of a normal recovery,” says Dr. Robert Rosenwasser, chair of neurological surgery at Thomas Jefferson University. “If you’re unsure whether or not you’re having a stroke, it’s always safer to visit the hospital or call 911.”

When considering the signs and symptoms of stroke, BE FAST is most helpful in summarizing important clinical facts: acute changes in balance, vision (eyes), facial movement, speech, and arm strength, then time is of the essence as these are signs of an acute stroke.

Lifesaving Treatments for Stroke Patients

About 87% of strokes are ischemic—caused by a blood clot in the artery that supplies blood to the brain. Thankfully, treatments exist to prevent further damage for patients who suffer from an ischemic stroke; however, these treatments must be given within an appropriate amount of time to be effective.

The most common first line of defense for ischemic stroke is tissue plasminogen activator (tPA), a blood clot-dissolving drug administered through an IV that can help patients when given within three hours of symptoms onset. If tPA doesn’t dissolve the blood clot, a neurosurgeon can resort to mechanical or endoscopic thrombectomy—a procedure to remove the blood clot through surgery.

Telemedicine at Participating Hospitals

During the COVID-19 pandemic, telemedicine has become commonplace. But when it comes to stroke treatments, hospitals have been using telemedicine to communicate for over a decade.

“Telemedicine revolutionized the way we manage strokes,” says Dr. Stavropoula Tjoumakaris, a neurosurgeon at Thomas Jefferson University Hospital. “We’re able to connect to small hospitals who may not be designated stroke centers and help them administer lifesaving treatments to patients in a timely manner.”

When hospitals use a telemedicine service, like Jefferson’s JET, a neurologist or neurosurgeon can remotely evaluate stroke patients so they can get the care they need quickly—without wasting precious time traveling to a comprehensive stroke center. In a recent study of tPA-eligible stroke patients who visited a hospital in a telemedicine stroke network, nearly 100% of them received tPA. “This means if you visit a hospital in a telemedicine stroke network, you are 100% likely to receive intravenous lifesaving medicine,” says Dr. Tjoumakaris.

Jefferson’s Mobile Stroke Unit

As another line of defense against strokes, Jefferson Health has introduced a mobile stroke unit—an emergency response vehicle designed to treat stroke patients. “The mobile stroke unit contains a CT scanner, along with specialized EMS personnel who have been trained in stroke management,” says Dr. Tjoumakaris.

Inside the mobile stroke unit
A specialized emergency medical technician in the mobile stroke unit, connecting with vascular neurosurgeon Dr. Pascal Jabbour through telemedicine.

When the mobile stroke unit responds to a 911 call for stroke symptoms, the patient will be evaluated and scanned quickly to determine the best course of treatment. “If they’re eligible, patients can receive tPA within the ambulance and, if they meet surgical criteria, will be taken right to a comprehensive stroke center to be seen by a neurovascular specialist,” says Dr. Tjoumakaris.

Jefferson mobile stroke unit ambulance
Jefferson’s Mobile Stroke Unit

The mobile stroke unit gives the Jefferson Health team the ability to evaluate patients and give them treatment before arriving at the emergency room—potentially saving millions of brain cells that otherwise would have been lost in transit. “When it comes to having a stroke, every minute counts,” says Dr. Rosenwasser.

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From the Experts, Healthy You