MORRISTOWN, NJ – Time is of the essence when it comes to identifying and treating symptoms of stroke. It’s widely accepted that the sooner treatment is provided, the better the outcome will be. However, new research suggests that all hope isn’t lost for certain types of stroke victims whose symptoms aren't treated until later in time after last being seen as "normal."
Such are the recently-published findings of a study named 'DAWN,' which tracked the outcomes of treatment to 206 patients between 2015 and 2017 who experienced stroke upon awakening from sleep or via small, 'slow growing' strokes that began within a six- to 24-hour window prior to last being seen as normal.
"This population is estimated to represent one-quarter to one-third of all stroke victims and generally has good-to-excellent backdoor blood flow even when the main artery is fully blocked, which results in the stroke damage developing very slowly," said Andrew Demchuk, M.D., director of the Calgary Stroke Program, professor in the Department of Clinical Neurosciences for the Cumming School of Medicine at the University of Calgary in Canada, and one of the world’s leading experts and trialists in stroke research and treatment today.
"Therefore, much of the brain is still alive for many hours, which allows for benefit when the main artery is reopened by thrombectomy, or within artery removal of the clot by catheters."
Demchuk presented the DAWN study findings to nearly 200 physicians, nurses and other medical professionals from hospitals throughout New Jersey during Atlantic Neuroscience Institute’s 18th annual Stroke Symposium, an event which Atlantic Health System has hosted each May since 2001 in commemoration of Stroke Awareness Month.
"The study reveals that we have a 24-hour window to perform a thrombectomy with success in select patients, so screening is essential," said Demchuk, who suggested that hospitals utilize specialized screening software which provides immediate information on the extent of at-risk brain and brain that has already died.
"DAWN proves to us that some patients can still be helped and will benefit from thrombectomy treatment delivered well out in the time window," he said, "though anyone having a stroke should take action as quickly as possible to achieve the best outcome, since the earlier we remove the clot in the artery the less brain that dies."
"The DAWN trial validates the success of a clot-removing thrombectomy procedure involving the use of a safe stent device within this patient population and confirms that we have a way to identify patients with an evolving major stroke and can successfully help break that cycle," said Ronald Benitez, M.D., chief of Endovascular Neurosurgery at Overlook Medical Center in Summit, president of Atlantic Neurosurgical Specialists, and fellow presenter at the Symposium. He noted, however, that “earlier treatment is always better.”
On the Leading Edge
According to the CDC, nearly 800,000 Americans suffer a stroke annually (rendering stroke one of the leading causes of long-term disability) and some 140,000 of those cases prove fatal. It’s a reality which continues to lead New Jersey’s Atlantic Health System–comprised of Overlook Medical Center in Summit (site of their Comprehensive Stroke Center) as well as facilities in Morristown, Newton, Pompton Plains and Hackettstown–to investigate and capitalize on the most cutting-edge technology, techniques and research in the field of stroke treatment and management.
Among these is Atlantic Health System’s widespread use of Telestroke, a portable unit which facilitates video communication with a stroke neurologist who performs a neurological evaluation of the patient via camera while in transit to the emergency department. Such innovative technology enables appropriate treatment to occur both en route and immediately upon arrival, thereby streamlining the process and minimizing critical 'door to needle' time for treatment of a stroke.
Other topics covered at the Stroke Symposium included best practices in the use of CT imaging for strokes, new digital approaches for surgeons in the treatment of large vessel strokes, and the growing use of tenecteplase (‘TNK’) over alteplase (‘TPA’), an FDA-approved clot-busting drug which can reverse the effects of a stroke for those who are medically eligible to receive it.
Presenting both the most prominent experts and the latest research in the field, “Atlantic Neuroscience Institute’s annual Stroke Symposium is an example of Atlantic Health System’s continued high-level commitment to and investment in the neurosciences and stroke treatment in particular,” Benitez said. “It’s exciting to be on the leading edge of research and treatment in the field.”
Stroke: A Time to Act FAST
In the event of a stroke, people are encouraged to remember the acronym ‘FAST’:
· “F” is for Face – does one side of the face droop?
· “A” is for Arms – when raising the arms, does one arm drift downward?
· “S” is for Speech – is speech slurred or strange?
· “T” is for Time – it’s time to call 9-1-1 immediately if you observe any of these signs
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