Used quickly, stroke drug can help

For people who have suffered a stroke, lingering disabilities are a wrenching reminder of what their lives used to be. A lopsided smile, difficulty moving an arm or a leg, trouble articulating thoughts -- all can be among the devastating and frequently permanent consequences of a stroke. In fact, of the almost 6 million Americans who have had a stroke, only 10% will recover completely.

The numbers shouldn't be this grim.

The use of a drug called tissue plasminogen activator, or tPA, can improve the chances of recovery by up to 30%, studies have shown. The tPA dissolves the blood clots responsible for causing most strokes, thereby restoring blood flow to the brain -- but most stroke victims don't get it.

"Less than 5% of stroke patients actually receive tPA," says Dr. Bruce Ovbiagele, director of the Olive View -- UCLA Stroke Program and a spokesman for the American Stroke Assn.

Time constraints are the main reason. If too much time passes, the damage caused by the clot is no longer reversible. To be effective, tPA must be given within three hours after stroke symptoms begin. In fact, the sooner it's administered, the better. "After three hours, it's a case of diminishing returns," Ovbiagele says. "The risks associated with tPA use begin to outweigh the potential benefits."

Administering the drug quickly isn't easy. For starters, most patients don't get to the hospital fast enough. A study published in May by the federal Centers for Disease Control and Prevention found that fewer than half of all stroke victims arrived at the ER within two hours of developing symptoms.

Frequently, victims simply don't recognize that they are experiencing a stroke. "People really don't know much about strokes," Ovbiagele says. "Only about 27% of the public can name one stroke symptom." And, in some cases, cognitive problems such as confusion caused by the stroke can impair a person's ability to understand what is happening.

Many people don't take appropriate action even after they realize they need help. Taking an ambulance is the quickest way to get to the hospital, but instead of dialing 911, people frequently call on friends or family members for assistance -- or they try to contact their personal healthcare provider for guidance. Only half of all stroke victims in the CDC study arrived by ambulance.