When it comes to treating a stroke, timing is everything. For the vast majority of adults who suffer a stroke, there is a three-hour “Golden Window” of opportunity in which, if they are treated quickly, significant damage to the brain can be avoided. Too often, however, symptoms are not recognized fast enough, and loss of blood flow to part of the brain causes permanent injury.

Stroke is a brain attack. It occurs when an artery bringing blood to the brain becomes blocked or ruptures, depriving part of the brain from receiving the oxygen it needs. The affected portion of the brain loses function, causing symptoms to appear. Once a stroke is experienced, it is common to have additional strokes or transient ischemic attacks.

Transient ischemic attack (TIA) is a “warming stroke” in which a temporary loss of blood flow causes brief loss of function, such as weakness of an arm and/or leg, lasting a few minutes to several hours. Even though function returns to normal, a TIA is a serious warning sign of a potential more permanent stroke, and you should seek immediate medical attention.

The Main Line Health Stroke Program, directed by Gary Friday, MD, MPH, has special stroke teams, written protocols and other services to treat patients with acute stroke quickly and effectively. Each of the Main Line acute care hospitals uses the latest treatment protocols and the crucial three-hour “Golden Window” of opportunity from the onset of symptoms as a target treatment time for all stroke patients. This includes the use of the “clot-buster” tPA (tissue plasminogen activator), the only drug approved for treating stroke, and found to significantly improve outcome when given within the three-hour timeframe. Stroke rehabilitation is coordinated through Bryn Mawr Rehab, which has a specialized inpatient unit.

Symptoms of a stroke include sudden: confusion, trouble speaking or understanding; trouble walking, dizziness, loss of balance or coordination; weakness or numbness of the face, arm and/or leg, especially on one side of the body; trouble seeing in one or both eyes; and severe headache with no known cause.

Risk factors for stroke are age (the older a person gets, the greater the risk for stroke); gender (men are at greater risk); race (African-Americans have a higher risk for stroke). Risk factors that are manageable are diabetes; high blood pressure and heart disease. Finally, the best thing is to prevent stroke from occurring in the first place.

You can reduce your chances of stroke by leading a healthy lifestyle. If you smoke, stop. Lower cholesterol and lipid levels, become physically active, limit alcohol intake, and see your doctor to check for stroke risk factors.

-- Thomas Graham is system chief of the Division of Neurology for the Main Line Health hospitals of Paoli Memorial, Bryn Mawr and Lankenau.

Published:5-7-2001