Of course 'Time is Brain'. Then why aren't you proposing the use of much faster stroke diagnosis tools?
Maybe you want these much faster objective diagnosis options.
Hats off to Helmet of Hope - stroke diagnosis in 30 seconds; February 2017
Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds March 2017
New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017
The latest here:
Treating Stroke From Inside the Blood Vessel
Time Matters
Dr. Sang and associates looked at how well people recovered after treatment for a stroke due to a blockage in the basilar artery. The basilar artery is critical to the brain because it brings blood to deep brain structures like the brainstem, which is important in controlling involuntary body functions such as breathing. The treatment they studied is called endovascular therapy (EVT). More specifically, they looked at time to treatment (which they measured as onset to puncture time [OPT]). In other words, once the stroke had occurred, they looked at the connection between when the treatment was given and how well the person recovered.
How Was the Study Done?
This study was done in China. Forty-seven stroke centers collected information from January 2014 to May 2019. The researchers identified 829 people who had had a basilar artery stroke. Of these, there were 639 patients whose basilar artery stroke was treated with EVT (that is, therapy that is performed inside the affected blood vessel). The study carefully evaluated these patients, looking at 2 endpoints. First, the authors measured how well the person was doing 90 days after the stroke. They used the Rankin Scale, a commonly used scale that measures the degree of disability in people who have had a stroke or who have a neurologic disability. In addition, they looked at the person's functional independence following the stroke.
The authors divided the group into 4 smaller groups. The groups were categorized by the amount of time that had passed between the onset of each person's stroke and the time they had received treatment (in this case, the time to EVT). The treatment groups were those who had treatment less than 4 hours, 4–8 hours, 8–12 hours, and more than 12 hours after stroke. As a control, the researchers compared the group of people with EVT against those who were treated with medicines alone.
What Did They Find?
First, the researchers observed that basilar artery stroke was often very serious: 46% of the patients whose data the researchers studied had died less than 90 days after their stroke. A total of 7.2% of people who had received EVT developed bleeding in the brain (called a hemorrhage) within 48 hours of the therapy. Of the people who had bleeding, the majority were treated with EVT more than 4 hours after their stroke. Those who had EVT less than 4 hours after their stroke were unlikely to develop bleeding in the brain. In other words, a longer time to treatment seems to have correlated with a higher risk of bleeding.
Of the patients who survived their stroke, 32.2% had a favorable outcome, and 27.5% regained functional independence. Those who received treatment more quickly (less than 4 hours after their stroke) had better outcomes overall than those who were treated later (more than 4 hours after their stroke). The researchers found that time was an important factor in the endovascular treatment of basilar artery stroke. The longer it took to get to treatment, the worse a person was likely to do. When the researchers looked at the results, they found there was a point of diminishing returns. There was a loss of the benefits of EVT in people who were treated more than 9 hours after their stroke. However, that does not mean that everyone treated more than 9 hours after their stroke did poorly. Some people who received EVT 9 hours or more after basilar artery stroke did well. These people were more likely to have had a smaller, less debilitating stroke than those who did poorly.
What Does This Mean?
Many trials in stroke treatments have shown that “time is brain.” This means that every minute counts when it comes to stroke treatment. The longer it takes to reach treatment, the greater the degree of neurologic injury is likely to be. In this study, the authors found the same result. In fact, they estimated that the chance of a favorable outcome decreased by 2.3% for every hour treatment was delayed. In addition, the chance of dying as a result of the stroke increased by 2.0% for every hour that the EVT was delayed. In short, the quicker a stroke is diagnosed and treated, the better recovery typically goes, and the more likely the person is to have a greater return of neurologic function.
More at link.
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