ROANOKE TIMES
Copyright (c) 1995, Roanoke Times
DATE: Thursday, December 14, 1995 TAG: 9512140057
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: BOSTON
SOURCE: Associated Press
For the first time, doctors have an emergency treatment for strokes - a medicine that can help victims escape the permanent brain damage that leads to paralysis and loss of speech.
A landmark government study published today shows that quick injections of the clot-dissolving drug TPA - tissue plasminogen activator - dramatically improve the chances that stroke patients will pull through with few lasting effects.
``It is the entrance of a new era in the treatment of acute stroke,'' said Dr. Philip Wolf of Boston University Medical School.
Until now, doctors have been helpless to do anything for people rushed to emergency rooms in the first hours of a stroke, a brain-wrecking catastrophe that afflicts about 500,000 Americans annually. Strokes are the leading source of adult disability and the No. 3 cause of death after heart disease and cancer.
Prompt treatment is essential. Indeed, giving TPA too late can do more harm than good, triggering disastrous bleeding in the brain.
This makes the use of TPA a high-stakes balancing act: Given to the right stroke patient, it can prevent lifelong disability. Given to the wrong one, it can kill.
To be effective and safe, experts say TPA must be administered within the first three hours of symptoms. Doctors must also give a CT scan first to make sure the stroke results from a blood clot in the brain - as about 80 percent of all strokes do - and not bleeding from a broken blood vessel.
Even when used properly, the treatment touches off bleeding in the brain in 6 percent of patients. However, the study concludes this hazard is more than offset by the reduction in symptoms among stroke survivors.
The study, overseen and financed by the National Institute of Neurological Disorders and Stroke, was published in the New England Journal of Medicine.
TPA and similar drugs have already revolutionized the care of heart attacks. They dissolve blood clots that become lodged in the heart's arteries, preventing the death of heart tissue.
Experts caution, however, that sorting out which stroke patients should get TPA will be harder than treating heart attack victims, since the consequences of a mistake are so dire.
``The worst thing that could happen would be to have everybody adopt this as a sound-bite headline and say all patients with stroke get TPA,'' said the head of the institute's stroke division, Dr. Michael Walker. ``Unfortunately, that is often what happens when these sorts of things come out.''
LENGTH: Medium: 54 linesby CNB