With stroke, time lost is brain lost. I do not know who to credit with originally making that statement, but it succinctly gets its point across. At the risk of being redundant, though, what does the phrase mean? A stroke occurs when blood supply to part of your brain is interrupted. Research shows that for each minute of a stroke, the brain loses approximately 1.9 million neurons. Put another way, the ischemic brain ages 3.6 years for each hour without treatment. It is clear that if there is a suspicion of stroke, providers need to act fast. Loss of blood supply can be caused by loss of blood flow (ischemia) or when a vessel in the brain bursts (hemorrhage). There also exists a type of ischemic stroke called a transient ischemic attack (“TIA”), which is temporary interruption of blood flow that resolves itself. Ischemic strokes are by far the most common type of stroke.

So, what are stroke symptoms? The classic symptoms are facial drooping, arm weakness, and slurred speech. Symptoms, though, vary based on the area with lost blood supply so loss of balance or coordination, loss of vision, or sudden headache (“worst headache of my life”) are somewhat common symptoms. 

Obviously, prompt identification and treatment are critical to stop further loss of brain tissue. For most ischemic strokes, the best early treatment is t-PA, an injectable “clot-busting” drug that dissolves clots quickly. Typically (with some exceptions, of course) the drug needs to be administered within three hours of first symptoms. Beyond that timeframe, the clots will need to be removed manually via a small catheter (tube) inserted into the patient’s artery so it can be maneuvered to the clot and retrieved.  

If the stroke is not treated soon enough, though, the patient may have a devastating injury. Delays occur when providers fail to recognize the significance of symptoms the patient is exhibiting, confuse the symptoms for other conditions, or simply act too slowly. A quick neurological examination may be done by most providers to try to rule out stroke. Even so, symptoms may be more commonly missed when the patient is exhibiting “atypical” stroke symptoms such as loss of vision, loss of coordination, or confusion. Or if the patient is having a TIA and symptoms may not be present in the exam room. We have also seen where providers simply did not believe our client’s reports of symptoms and so dismissed them.

Stroke, if not treated in time, may require years of therapy, cause permanent deficits, and could even lead to death. So, again, time lost is brain lost.