Medications

• Drugs for acute stroke: Currently, only 1 medicine is approved to treat new strokes. It is the clot-busting medication called tissue plasminogen activator (t-PA). This medicine works with the body's own chemicals and helps dissolve the blockage in the blood vessel in the brain that may be causing the stroke. It is the same drug that is often used to treat heart attacks. This is not a miracle drug, but studies of t-PA have shown that it can reduce disability from stroke by 30%. It has potentially serious side effects that include bleeding within the brain. This usually occurs in people who have serious strokes or who were not going to do well regardless of treatment (see the illustration of how effective this drug is). Not all people with stroke can receive the clot-busting drug t-PA.
  
  
  • For t-PA to work, it must be given within 3 hours of the onset of symptoms. The earlier the drug is given within those 3 hours, the better it works. Symptom onset is defined as the time you were last known to be OK. If you awaken with symptoms, the symptom onset time is set back to the hour you went to sleep. This criterion alone may exclude many people from receiving this drug. This is also why it is so important to get to a stroke team for evaluation.
    
    
  • You must not have any evidence of bleeding on the CT scan of the head. The clot-busting medication is not used for anyone having a hemorrhagic stroke. That is why it is critical to know what kind of stroke you are having.
    
    
  • The doctor evaluates whether you should receive treatment with this drug and discuss the risks and benefits of giving it. Some doctors may believe that the drug is less effective. If given, strict guidelines must be met for the administration of this drug to prevent bad side effects.
  
  
• Other treatments for acute stroke are being tested. At some hospitals, clot-busting drugs are given through a small catheter that, through an IV, is threaded up into the neck and into the artery where there is a blockage. This treatment can potentially be used up to 6 hours after onset of stroke symptoms. Many other new treatments for stroke are being developed. It may be possible to participate in a study of a new stroke drug or other acute treatment.

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