A door-to-treatment time of 60 minutes or less is the goal. This 60-minute period is often referred to as the “golden hour” of acute ischemic stroke treatment during which a focused diagnostic workup must be completed to rule out conditions that may mimic stroke as well as contraindications to rt-PA administration.
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.
After receiving prompt treatments during stroke attacks, the golden period of post-stroke rehabilitation is within 3-6 months. Rehabilitation helps stroke survivors relearn skills that are lost when part of the brain is damaged.
“The first three months after a stroke are the most important for recovery and when patients will see the most improvement,” says Raghavan. During this time, most patients will enter and complete an inpatient rehabilitation program, or make progress in their outpatient therapy sessions.
Diffusion MRI or diffusion-weighted imaging (DWI) is the gold standard for the imaging diagnosis of AIS, detecting it as early as 30 min after the beginning of symptoms.
Therefore, in simple terms, a gold standard test refers to a diagnostic method with the best accuracy; whereas ground truth represents the reference values used as standard for comparison purposes.
MRIs are also more accurate than CT scans since they are far more sensitive. They show all issues related to a stroke and any other diseases or concerning factors within the brain. MRIs are excellent at detecting even tiny abnormalities, which are often too small to be clearly seen in a CT scan.
Ischemic stroke
If you arrive within four-and-a-half hours of the onset of the stroke, you might receive a medication called IV tPA (intravenous tissue plasminogen activator). This medication is FDA-approved and is the standard-of-care for people with ischemic stroke presenting to the hospital early.
Because the cause of a stroke and the amount of damage it causes in the brain vary widely, there's no “typical” duration of a stroke. Some strokes last for a few minutes while others continue for hours or even days.
Ischemic stroke was most frequent in the anterior circulation (87.7%). Within 72 hours after stroke onset 48.0% of the patients had impaired arm and hand function and this was positively associated with higher age (p < 0.004), longer stay in the acute care (p < 0.001) and mortality in acute care (p < 0.001).
Few patients recover fully and most are left with some disability, but the majority exhibit some degree of spontaneous recovery. Doctors and scientists don't fully understand how this happens, because the brain does not grow new cells to replace the ones damaged by the stroke.
Because every stroke is different, there is no set pattern for recovering from one. The quickest recovery takes place in the days and weeks after a stroke. But recovery can continue for months and years after a stroke.
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The figures show that 38% of people suffering strokes are middle aged (40-69) – up from 33% a decade ago. The average age for a woman suffering a stroke has dropped from 75 to 73 and for men it has dropped from 71 to 68.
Time of Day
Both STEMI and stroke are most likely to occur in the early hours of the morning—specifically around 6:30am.
Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
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.
An MRI can also detect old strokes for decades after they happen. The fastest type of MRI is diffusion-weighted imaging (DWI). It measures shifts in fluid in the brain and can detect a stroke soon after its onset. An MRI can also detect evidence of past strokes.
Yes, you can have a stroke and not know it. A stroke's effects can be undetectable if the stroke is small or if the tissue damaged does not serve a critical function. Evidence of the stroke would show on a CT scan or an MRI of the brain, but it might not produce symptoms.
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Patients are as symptom controlled as possible. Place of care – patients are enabled to live well and die well in their preferred place of care. Security and support – better advance care planning, information, less fear, fewer crises/admissions to hospital.