DARA JAMIESON, MD: Acute stroke means that the process of brain damage is occurring by the minute. As far as the patient is concerned, the patient will notice the sudden onset of neurologic symptoms. One minute the patient may be home relaxing and all of a sudden the patient will notice an inability to move say the right side of her body and difficulty speaking. That's a patient who is having an acute stroke who needs to recognize those symptoms immediately, needs to get to the hospital immediately and get treatment immediately.
PAUL J. MONIZ: Walk us through, Dr. Sacco, what's happening. 911 is called. Hopefully, they are either calling right away -- we should bring that up right at the top. Don't wait.
RALPH L. SACCO, MD: Don't wait.
PAUL J. MONIZ: How quickly should they call? Two minutes after symptoms? How important is that call?
RALPH L. SACCO, MD: If you have these neurologic symptoms that Dr. Jamieson just mentioned, then you need to call right away. You don't want to wait. The key for stroke treatment is less than three hours. That's why we use the term "time is brain." The best effective therapy we have only works if you get it within three hours.
So the person calls 911. In most cities, 911 gets there right away and gets them to the nearest hospital. At the hospital they'll be stabilized in transport and then the key is to find out what kind of stroke it is. So often a brain scan is done. That brain scan can tell us whether it's a bleeding stroke or an ischemic stroke.
If it's one of the ischemic strokes, which are the majority -- close to 85 percent -- then maybe you would be a candidate for these clot-busting medicines to reduce the damage from stroke and improve outcome.