For treatment of stroke, “time is brain.” This means the sooner that treatment can restore blood flow to the brain, the more likely the patient will have a good outcome. I have previously written about one such treatment: clot busting medications. Clot busters, such as tPA, must be given within 4.5 hours of the onset of stroke. However, another treatment — endovascular intervention — can be started after the 4.5 hour window for clot busters has expired. However, the same rule — “time is brain” — applies, meaning earlier treatment leads to better outcomes.
A thromboembolic stroke occurs when blood clots clog arteries that perfuse the brain with blood and oxygen. As a neurosurgeon once told me, the brain is an unforgiving organ. Once brain cells die from lack of oxygen, they do not recover. Clot busting medications melt clots away, thereby restoring blood flow to the brain before brain cells die. Endovascular treatment has a similar effect; angiographic equipment is inserted into the clogged artery to restore blood flow. The equipment can be used to mechanically open the artery (angioplasty) or it can be used to apply pinpoint application of clot busting medications.
A recent study published at the International Stroke Conference shows that the earlier endovascular intervention is attempted, the better. The study showed that for every hour of delay in undertaking treatment, the likelihood of a good outcome fell by 10%. Thus, earlier treatment improves outcomes, while a delay in treatment leads to worse outcomes.
We have handled a number of stroke-related cases. The basis of such claims lies in the fact that a delay in diagnosis and treatment leads to poor outcome. A medical negligence claim may arise if treating physicians unnecessarily delay treatment and the patient suffers a worsened outcome as a result. (Note: Under Ohio law, the terms “medical negligence” and “medical malpractice” are used interchangeably.)