The most widely known and the only FDA-approved drug for treatment of ischemic stroke — intravenous tPA (tissue plasminogen activator) — can reverse stroke if given to carefully selected patients within a few hours of stroke onset.
Emergency IV medication.
An IV injection of recombinant tissue plasminogen activator (TPA) — also called alteplase (Activase) or tenecteplase (TNKase) — is the gold standard treatment for ischemic stroke. An injection of TPA is usually given through a vein in the arm within the first three hours.
tPA (tissue plasminogen activator)
tPA is short for tissue plasminogen activator and can only be given to patients who are having a stroke caused by a blood clot (ischemic stroke). It can stop a stroke by breaking up the blood clot. It must be given as soon as possible and within 4½ hours after stroke symptoms start.
The reason the first hour is golden is because stroke patients have a much greater chance of surviving and avoiding long-term brain damage if they arrive at the hospital and receive treatment with a clot-busting drug called TPA within that first hour.
Anticoagulant medications
It is given to people who have a history of blood clots, and also those who have had a stroke caused by a blood clot. Your doctor may prescribe anticoagulants & antiplatelets such as warfarin that prevent the formation of another clot.
With stroke, “time is brain,” meaning that the sooner treatment begins, the better. Knowing the signs of stroke and calling 911 immediately can help save a relative, neighbor, or friend. With timely treatment it is possible to save these cells and greatly reduce and reverse the damage.
Antiplatelets (Aspirin, ASA, acetylsalicylic acid, clopidogrel, dipyridamole, ticlopidine) Antiplatelets help stop dangerous blood clots from forming. This can reduce the risk of heart attack or stroke. Aspirin is the most common antiplatelet.
If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, you may get a type of medicine called a thrombolytic (a “clot-busting” drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic. tPA improves the chances of recovering from a stroke.
Unfortunately, the blood thinners used to prevent such blood clots can increase the risk of bleeding in the brain, a cause of hemorrhagic stroke.
A silent stroke is most often caused by reduced blood flow in one of the smaller arteries that feed the brain. It can occur without noticeable symptoms if it affects a part of the brain that doesn't control major movements or vital functions.
For this reason, the 60 minutes after the onset of stroke symptoms are known as “the golden hour.” If treatment can be initiated within this brief window, the patient's outcome is likely to be better.
Hemorrhagic strokes are particularly dangerous because they cause severe symptoms that get worse quickly. Without fast medical attention, these strokes often cause permanent brain damage or even death.
If you and your doctor decide that daily aspirin is right for you, your doctor will recommend a dose of aspirin and how often to take it. Low-dose aspirin (81 mg) is the most common dose used to prevent a heart attack or a stroke. A typical schedule is to take aspirin every day.
Taking aspirin isn't advised during a stroke, because not all strokes are caused by blood clots. Some strokes are caused by ruptured blood vessels and taking aspirin could make these bleeding strokes more severe.
Some people will experience symptoms such as headache, numbness or tingling several days before they have a serious stroke. One study found that 43% of stroke patients experienced mini-stroke symptoms up to a week before they had a major stroke.
How Does a Stroke Impact Life Expectancy? Despite the likelihood of making a full recovery, life expectancy after stroke incidents can decrease. Unfortunately, researchers have observed a wide range of life expectancy changes in stroke patients, but the average reduction in lifespan is nine and a half years.
Stroke symptoms that go away on their own are still a medical emergency. Get to a hospital as fast as you can. Every stroke is a medical emergency because it means that blood flow to part of the brain has been interrupted.
By opening a blocked blood vessel and restoring blood flow, tPA can reduce the amount of damage to the brain that can occur during a stroke. To be effective, tPA and other drugs like it must be given within a few hours of the stroke symptoms beginning.
Sometimes the blood clot goes away before it causes permanent brain damage. However, sometimes the clot remains and causes a type of stroke called a venous infarct, or may cause bleeding into the brain (brain hemorrhage).
There are three general categories of drugs that are commonly used to prevent or treat blood clots (thrombosis): anticoagulants, fibrinolytics, and antiplatelet medications. Some of these (Pradaxa, Angiomax, ReoPro) may be unfamiliar, while others (warfarin, heparin, aspirin) are generally household names.
Early treatment for ischemic stroke (clot)
It must be given as soon as possible, ideally within 4½ hours after stroke symptoms started.
Note the time you first see symptoms
A clot-busting medication called tPA, or tissue plasminogen activator, can be given to someone if they're having a stroke, potentially reversing or stopping symptoms from developing. But it has to be given within 4.5 hours of the start of symptoms, Dr. Humbert says.