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Time Is a Key Factor in Stroke Treatment

Henry Tang, D.O. Stroke

Time is brain. Remembering that simple sentence can make all the difference if you or someone around you ever experiences stroke. Time is critical because a stroke starves brain tissue of life-giving oxygen, causing it to start to die in as little as four minutes after the beginning of a stroke. When brain tissue dies, it is gone forever.

The speed and severity of brain damage from stroke depends on a complicated mix of factors, but the bottom line is this: The quicker you recognize the symptoms of stroke and get medical help, the better the chances are to prevent devastating brain damage—and possibly even death.

One of the best treatments for stroke—a clot-busting drug called tissue plasminogen activator, or tPA—can be used only within the first three to 4-1/2 hours after the onset of a stroke. The effectiveness of other treatment options also diminishes as time passes. Eventually, the damage is not reversible even if the clot is broken up or physically removed.

The first important step you can take to save time—and brain tissue—during a stroke begins right now: Learn the warning signs of stroke. The American Stroke Association has created a model called FAST to help you learn how to spot a stroke and how to respond:

F is for face drooping. Does one side of the person’s face droop, or does the person say his or her face feels numb? When you ask the person to smile, is the smile uneven?

A is for arm weakness. Does the person report that one arm is weak or numb? When you ask him or her to raise both arms, does one arm drift downward?

S is for speech difficulty. Is the person’s speech slurred, or is he or she unable to speak or hard to understand? Can the person repeat a simple sentence back to you, such as “The sky is blue”?

T is for time to call 911. If someone shows any one or more of the symptoms above—even if the symptoms go away—call 911 immediately. If possible, be sure to note the time when the symptoms first appeared. That will help the medical team provide the most appropriate care to the person experiencing the stroke symptoms.

While you’re educating yourself about stroke, don’t forget to teach your children the warning signs too. The concepts of the FAST model are simple enough for even elementary-age kids to understand. For a lively, musical way to learn FAST, go to and search “stroke heroes act fast.”

Another critically important way to save precious time/brain tissue during a stroke is to resist the urge to drive in a private vehicle to the hospital. Instead, you should always call 911 if you or a person around you shows the symptoms of stroke—no exceptions! Many people hesitate to call 911 because of the cost or the potential embarrassment of having an emergency vehicle show up at their home. But you must ask yourself this: “Am I willing to risk spending the rest of my life as an invalid—or even dying?”

Calling 911 doesn’t just summon an ambulance to your location; it puts into motion a series of events that prepares the hospital to provide the fastest and best possible care for you from the moment you arrive. When paramedics radio the hospital emergency department that they are transporting a suspected stroke patient, an emergency physician is notified, a neurologist is called in, the hospital’s CT scanner is made available, the pharmacy is alerted and other protocols are put into place. As a result, the team is ready to get to work the moment the ambulance arrives.

If someone arrives by private vehicle, on the other hand, they must first speak with a triage nurse in the lobby then see an emergency physician. Only after that is the team assembled—a process that can require precious minutes at a time when the brain is under attack.

Even though stroke isn’t pleasant to think about, it is certainly worthwhile to spend some time now to educate yourself and to plan how you will react if you ever find yourself experiencing it firsthand.

Henry Tang, D.O., is a Simi Valley neurologist and medical director of the stroke program at Simi Valley Hospital.