Stroke treatment advances: minimizing neurological damage.

• Author: West, Gail
• Position: HEALTHCARE

True story: A few years ago, two executives were sitting in their Anchorage conference room discussing the future of their engineering business. Hopeful discussion, bright future. Then suddenly, one of the two felt dizzy and lightheaded, saw his hands shaking almost uncontrollably. He waited a bit and the symptoms settled slightly. He went to his office and tried to make a phone call only to find he couldn't control his fingers sufficiently to dial. He waited a bit longer and all the symptoms vanished. Wrong answer! That man was very lucky. He had suffered only a transient ischemic attack (TIA), described by the American Heart and Stroke associations as a warning stroke. He didn't take it seriously, but it is serious--deadly serious.

According to the national Centers for Disease Control and Prevention, stroke is a leading cause of death in the United States, killing nearly 130,000 Americans each year. Alaska's Department of Health and Social Services said in a 2009 report that the state's stroke death statistics were higher than the national average.

Minimizing Damage

Death and debilitation from strokes, however, can be minimized and in many cases completely eliminated if the victim can get to an emergency room quickly enough. "Even if you're not sure what's happening," says Dr. Peter Osterbauer of the Alaska Neurology Center, "if you can get there within about three hours, you can be given the 'clot-busting' drug." That drug will help loosen the clot but has to be administered, Osterbauer emphasizes, within three hours of onset of symptoms.

Christie Artuso, the director of Neuroscience Services for Providence Alaska Medical Center, says the drug is called Activase and is the only such drug approved by the FDA for use in dissolving blood clots. "If we can administer the drug within ninety minutes, there is a strong possibility for complete reversal," Artuso says. "Every patient is a little different, and some may have a massive stroke, and the extent of the damage may determine how well we can reverse affects. Generally, though, the drug works well if administered within three to four and a half hours. We've seen patients given the drug recover in an hour, literally before our eyes."

Artuso adds that the Activase injection treats only the ischemic, not the hemorrhagic, stroke. "Approximately 87 percent of stroke patients are suffering from an ischemic stroke, so the treatment is focused on the most common type," Artuso says. "The most...