Why Time is Critically Important After a Stroke

When a stroke occurs, time means everything. Approximately 2 million brain cells die every minute during a stroke, which is why getting immediate care is crucial. When treatment is administered in the first three hours after signs of a stroke appear, it greatly reduces the effects.

What happens during a stroke?

The brain is the command center for our body, controlling our movements, managing our memories, thoughts, emotions and language while regulating bodily functions that are vital for life. To manage these complex tasks, the brain requires constant oxygen-rich blood flow.

“A stroke occurs when something interrupts the blood flow to the brain. This creates oxygen-starved brain tissue leading to brain damage if not reversed,” said James Pacelli, M.D., a neurologist with Penn Highlands Neurology. “Two types of strokes can occur. An ischemic stroke is caused by a blood clot obstructing blood flow to the brain, while a hemorrhagic stroke is caused by a ruptured blood vessel that blocks blood flow to the brain.”

Nearly 87% of all strokes are ischemic strokes. The main cause of this type of stroke is fatty deposits lining the vessel walls, which is called atherosclerosis — sometimes referred to as “hardening of the arteries.” A blood clot can form where the deposit is located and create an obstruction to blood flow, or it can form in another part of the body, break loose, enter the bloodstream and lodge in the brain’s blood vessels. Blood clots can also form in the heart and travel to the brain causing a stroke. This commonly occurs as a result of an irregular rhythm called atrial fibrillation, but can also be caused by disease of the heart valves. There are also several rare genetic conditions which increase spontaneous blood clotting and can lead to stroke.

Hemorrhagic strokes are the result of a ruptured blood vessel leading to bleeding into or around the brain. One of the most common factors leading to vessel rupture is hypertension, which chronically weakens the blood vessels’ walls. Other types of vascular abnormality that can lead to bleeding are aneurysms, which are an abnormal outpouching from the vessel wall, and arteriovenous malformations (AVMs), which are abnormal direct connections between arteries and veins.

Regardless of cause, time is critical! Brain cells begin to die right away making immediate emergency care crucial. You should always call 9-1-1 when someone is showing signs and symptoms of stroke.

How are strokes treated?

In order to promptly restore blood flow to the brain, doctors have several therapies to treat acute stroke patients. A drug called tissue plasminogen activator (t-PA) acts as a clot buster and can be given intravenously. This drug works to dissolve the clot and restore blood flow to oxygen-starved brain tissue. Sometimes the clot is too large and blocking a major brain blood vessel. In these cases, doctors can physically disrupt and mechanically extract the clot using interventional techniques.

Time is the crucial element in both cases. The window in which someone is eligible for t-PA is only up to four and a half hours from symptom onset. If a patient arrives after that time, they may only be eligible for clot extraction, but the longer the delay the less options that may be available. This is why it is so crucial to call 9-1-1 at symptom onset!

Because time is so critical, it is important to know the warning signs.

Use the acronym F.A.S.T. to spot the symptoms of a stroke quickly:

F = Face drooping. Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?

A = Arm weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S = Speech difficulty. Is speech slurred?

T = Time to call 911.

All Penn Highlands Healthcare emergency departments are prepared to identify and treat strokes as quickly as possible. Penn Highlands DuBois and Penn Highlands Mon Valley are designated Primary Stroke Centers. This certification from The Joint Commission recognizes hospitals that have the infrastructure, staff and training to identify and treat patients with the most complex strokes. In addition, Penn Highlands Elk is certified by the American Heart Association/American Stroke Association as an Acute Stroke Ready Hospital achieved for its dedication to providing stroke care to the community. To learn more, visit phhealthcare.org/stroke.