The reason the first hour is golden is because stroke patients have a much greater chance of surviving and avoiding long-term brain damage if they arrive at the hospital and receive treatment with a clot-busting drug called TPA within that first hour.
The answer is: The first minutes and hours after stroke symptoms first appear are precious. And getting the right care as soon as possible is critical.
For many patients, the blood clot can be treated with clot-dissolving medications like tissue plasminogen activator (tPA) or tenecteplase (TNK). The medication needs to be given within 3 hours of having a stroke, or for some eligible patients, up to 4 ½ hours after the onset of a stroke.
Ischemic stroke
If you arrive within four-and-a-half hours of the onset of the stroke, you might receive a medication called IV tPA (intravenous tissue plasminogen activator). This is a protein that your body makes to break up clots.
The first three days are of utmost importance for the recovery and survival rate of the stroke patient, since they can determine if the patient will have lifelong disabilities or leave the hospital and continue to be a productive part of the community.
For this reason, the 60 minutes after the onset of stroke symptoms are known as “the golden hour.” If treatment can be initiated within this brief window, the patient's outcome is likely to be better.
The first hour is considered to be the most crucial or in other terms “golden” because stroke patients have a high chance of survival and prevention of long-term brain damage if they receive medical treatment and drug therapy within the first 60 minutes of the onset of symptoms.
Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
Within 72 hours after stroke onset 48.0% of the patients had impaired arm and hand function and this was positively associated with higher age (p < 0.004), longer stay in the acute care (p < 0.001) and mortality in acute care (p < 0.001).
If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, you may get a type of medicine called a thrombolytic (a “clot-busting” drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic. tPA improves the chances of recovering from a stroke.
The result may be neurological, cognitive and physical disability or death. The longer the blockage, the greater the damage. That's why it's critical to get medical help as quickly as possible when signs and symptoms appear, Shafie says.
Don't wait to see if symptoms stop. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.
Time elapsed is one of the biggest determining factor in how much damage a stroke does to the brain. Every minute a stroke goes untreated, roughly 1.9 million brain cells die, which can lead to long-term disability and even death.
Blood pressure readings above 180/120 mmHg are considered stroke-level, dangerously high, and require immediate medical attention.
Medical experts often use the NIH Stroke Scale to determine the severity of a stroke. Patients that score between 21 and 42 (the highest possible score) are considered to have suffered a massive stroke.
Other brain cells die because they are damaged by sudden bleeding in or around the brain. Some brain cells die quickly but many linger in a compromised or weakened state for several hours. Stroke causes permanent brain damage over minutes to hours.
In many cases, stroke patients are discharged from the hospital to either a rehabilitation facility or their home within four to seven days.
The major risk factors for stroke include: High blood pressure. Diabetes. Heart and blood vessel diseases: Conditions that can cause blood clots or other blockages include coronary heart disease, atrial fibrillation, heart valve disease, and carotid artery disease.
For wake-up stroke, the midpoint between sleep onset (or last known to be normal) and time of waking-up must not exceed 9 h.
Few patients recover fully and most are left with some disability, but the majority exhibit some degree of spontaneous recovery. Doctors and scientists don't fully understand how this happens, because the brain does not grow new cells to replace the ones damaged by the stroke.
Immediately following a stroke, due to the damage inflicted, needs rest. While sleeping, the brain is healing, which is the process of reorganizing and figuring out how to turn itself back on. Brain reorganization takes a lot of rest, so during early post-stroke, sleeping a lot is encouraged.
Acting FAST is crucial
Nerve cells are the core components of the brain, spinal cord and central nervous system and the more that are lost, the greater the chance of slurred speech, paralysis and permanent disability.