As many as 65% ischemic stroke patients are not eligible for tPA).ĭoctors can’t administer tPA without determining the nature of the stroke and that can only be done by examining the brain with a CT scan or some other advanced brain-imaging device. (For that reason, the drug is also not given to patients on blood thinners or who have other complications. While the majority (about 85% in the US) are ischemic and caused by a blockage that can potentially be treated with tPA, the rest are hemorrhagic, caused by a ruptured blood vessel, and tPA can be be fatal in these strokes because it prevents the blood from clotting. In this case, the issue was that there are two kinds of stroke. But, as with most things in the world of stroke, there were complications. With tPA, emergency-room doctors at last had a way to treat patients. The longer the penumbra is deprived of blood, the less brain there is to save. While neurons in the immediate vicinity of the stroke can’t be saved, there’s a larger zone, called the ischemic penumbra, that can be rescued if blood flow can be restored. The goal of tPA is “reperfusion,” the act of returning blood flow to the injured part of the brain. The first-and to date only-medical breakthrough for stroke treatment came when a drug called tissue plasminogen activator (tPA, sold globally under the brand names Activase and Actilyse) was approved by the US Food and Drug Administration (FDA) in 1996. The bulk of progress in reducing stroke deaths has come from prevention, particularly the introduction of medicines to lower high blood pressure, a leading cause of stroke. Stroke was viewed as a dead end-for patients, for researchers, and for neurologists looking for solutions-and stroke nihilism still permeates the medical establishment. Once a stroke was identified, the patient was made comfortable and family members were given the bad news. Stroke weakens the immune system, making it harder for the body to fight lung infections that can occur when stroke victims, who can no longer swallow properly, wind up with food, water, or saliva in their lungs.įor most of history, health workers had no way to help stroke victims. Others die from complications like pneumonia, which can affect up to one-third of all stroke patients. ![]() “Time is brain” is a longtime cliche among stroke professionals, but it’s largely true.ĭeath follows when a stroke causes the brain to swell, starving it of oxygen, or because the stroke destroys the body’s ability to regulate breathing or blood flow. But the medical establishment has failed stroke patients not just because the research is hard, but because of misaligned incentives, the financial pressures of an industrial drug-development model, and sloppy science. The intricacy of the brain, the need for immediate action, and the variability of both strokes and the people who have them make designing and testing drugs an enormous challenge. Today, fewer than 5% of all stroke victims worldwide receive any treatment beyond basic palliative care, and the lack of effective stroke drugs remains one of the most glaring unmet needs in medicine.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |