THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Thursday, December 14, 1995 TAG: 9512140581
SECTION: FRONT PAGE: A12 EDITION: FINAL
SOURCE: ASSOCIATED PRESS
DATELINE: BOSTON LENGTH: Medium: 67 lines
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 little or no 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.
The discovery means strokes will have to be considered emergencies by ambulance crews, hospitals and victims themselves, since prompt treatment is essential. Indeed, giving TPA too late in the course of a stroke 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 safest, experts say TPA must be administered within the first three hours of symptoms. Further, doctors must give a CT scan first to make sure that 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 that 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 revolutionized the care of heart attacks. They dissolve blood clots that become lodged in the heart's arteries, preventing the death of heart tissue.
``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.'' ILLUSTRATION: Graphic
Now that emergency treatment for strokes is available, experts
say it is essential for people to learn the warning signs so that
they seek care quickly. The American Heart Association lists these
typical stroke symptoms:
Sudden weakness or numbness of the face, arm or leg on one side
of the body.
Sudden dimness or loss of vision, particularly in one eye.
Loss of speech or trouble talking or understanding speech.
Sudden, severe headaches with no known cause.
Unexplained dizziness, unsteadiness or sudden falls, especially
along with any of the other warning signs.
KEYWORDS: STROKES TREATMENT by CNB