A door-to-treatment time of 60 minutes or less is the goal. This 60-minute period is often referred to as the “golden hour” of acute ischemic stroke treatment during which a focused diagnostic workup must be completed to rule out conditions that may mimic stroke as well as contraindications to rt-PA administration.
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.
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 three months after a stroke are the most important for recovery and when patients will see the most improvement,” says Raghavan. During this time, most patients will enter and complete an inpatient rehabilitation program, or make progress in their outpatient therapy sessions.
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 medication is FDA-approved and is the standard-of-care for people with ischemic stroke presenting to the hospital early.
Mortality within 72 hours after stroke onset was 5.0% (32 patients) and a further 4.2% (27 patients) died within ten days. At discharge from the stroke unit, 63.9% of the 571 patients who survived went directly to their home with or without homecare and the other patients required further hospital based rehabilitation.
The main treatment for an ischemic stroke is a medicine called tissue plasminogen activator (tPA). It breaks up the blood clots that block blood flow to your brain. A doctor will inject tPA into a vein in your arm. This type of medicine must be given within 3 hours after your symptoms start.
The initial recovery following stroke is most likely due to decreased swelling of brain tissue, removal of toxins from the brain, and improvement in the circulation of blood in the brain. Cells damaged, but not beyond repair, will begin to heal and function more normally.
Physical therapy uses exercises to help you relearn movement and coordination skills you may have lost because of the stroke. Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading, and writing.
This is because the brain requires extra energy to heal the damage incurred, leaving less energy available for typical functions such as staying alert. Furthermore, studies have shown that sleep promotes neuroplasticity after stroke.
Time of Day
Both STEMI and stroke are most likely to occur in the early hours of the morning—specifically around 6:30am.
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.
Although just 10% of people fully recover from a stroke, 25% have only minor impairments and 40% have moderate impairments that are manageable with some special care.
Getting to the ER as quickly as possible is perhaps the most important part of managing a stroke because brain tissue can die at a rapid pace.
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 short answer is yes; the brain can heal after acute trauma from a stroke or brain injury, although the degree of recovery will vary. The reason the brain can recover at all is through neuroplasticity, sometimes referred to as brain plasticity.
Even after surviving a stroke, you're not out of the woods, since having one makes it a lot more likely that you'll have another. In fact, of the 795,000 Americans who will have a first stroke this year, 23 percent will suffer a second stroke.
Sleep disruption is very common after suffering a stroke, more than half of survivors have problems sleeping in the months following. Poor sleep can slow recovery, cause depression, and even lead to memory problems.
Limit foods high in saturated fat such as biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks. Limit foods which contain mostly saturated fats such as butter, cream, cooking margarine, coconut oil and palm oil.
Some movement and relaxation activities like yoga, Zumba or meditation are often available at leisure centres. These can be a good way to get moving after a stroke. They can also help you feel good and improve your mood.
Time management is of the utmost importance in patients with an ischemic stroke because the fibrinolytic/thrombolytic therapy must be administered within 3 to 4.5 hours after symptom onset to be effective.
CSC is the highest level of certification for hospitals with specific abilities to receive and treat the most complex stroke cases.