Dopamine beta-hydroxylase deficiency
May. 19, 2023
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A stroke is a brain attack. It is a sudden interruption of continuous blood flow to the brain and a medical emergency. A stroke occurs when a blood vessel in the brain becomes blocked or narrowed, or when a blood vessel bursts and spills blood into the brain. Just like a heart attack, a stroke requires immediate medical attention.
Some brain cells die because they stop getting the oxygen and nutrients needed to function. 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.
With stroke, “time is brain,” meaning that the sooner treatment begins, the better. Knowing the signs of stroke and calling 911 immediately can help save a relative, neighbor, or friend. With timely treatment it is possible to save these cells and greatly reduce and reverse the damage.
Strokes can be prevented and treated. Making lifestyle changes and getting regular medical and prenatal care can help prevent stroke and significantly reduce the risk for other disorders such as dementia, heart disease, and diabetes.
Warning signs and symptoms
Stroke warning signs are clues the body sends when the brain is not receiving enough oxygen. The key to recognizing stroke symptoms is that they appear suddenly.
People who have a stroke may not realize what is happening to them or mistakenly choose to ignore the signs, thinking the problem will pass. Even when people know there's a problem, they may not be able to call for emergency help on their own. The people around them might not know what is happening either, but they may recognize that something is wrong.
Call 911 immediately if one or more of the following symptoms occurs:
More rarely, people who may be having a stroke may have disorientation or memory loss, nausea, dizziness, or vomiting.
Sometimes the warning symptoms may last only a few moments and then disappear. These signs may indicate that someone is having a minor stroke or a transient ischemic attack (TIA).
The brain is nourished by one of the body's richest networks of blood vessels. A blockage or rupture in one of these blood vessels may occur in any area of the brain. Since each area is responsible for different functions, the effects of stroke may range from mild to severe disabilities depending on the type, severity, and location of the stroke. The symptoms may be temporary or permanent.
For example, the brain stem controls vital functions such as breathing, blood pressure, and heartbeat, and it connects the brain with the rest of the body. A stroke in the brain stem can be fatal or can leave someone in a “locked-in” state in which the person is paralyzed, cannot speak, and can only move the eyes up and down.
Types of stroke. There are two main types of stroke. Ischemic stroke, the most common type in the U.S., accounts for approximately 80 percent of all strokes. The other kind, called a hemorrhagic stroke, accounts for the remaining 20 percent.
Ischemic Stroke—An ischemic stroke occurs when the supply of blood to one or more regions of the brain is suddenly cut off or interrupted. It is similar to a heart attack, but it occurs in the brain and causes a lack of oxygen to millions of neurons and other brain cells fed by the blocked artery. It is most commonly caused by a blood clot or cellular debris (such as plaque—a mixture of fatty substances, including cholesterol) that blocks or plugs a blood vessel in the brain. Blockages that cause ischemic strokes stem from three conditions:
Blood clots are the most common cause of artery blockage and brain infarcts (damaged or dead areas of brain tissue). Blood clotting is necessary and helpful because it stops bleeding and allows the body to repair damaged small blood vessels at the site of injury. However, blood clots that form in the heart or an artery leading to the brain or in a large vein that drains blood from the brain can cause devastating injury by blocking normal brain blood flow.
The most common cause of stenosis is atherosclerosis—a condition where deposits of plaque build along the inside of arteries, causing thickening, hardening, and loss of elasticity of artery walls. It is the same condition that leads to heart attack. Arteriosclerosis is also thought to cause “diffuse white matter disease”—a common finding on MRI scans associated with damage to the wires, called axons, their insulating coating, called myelin, and leaky small blood vessels. Diffuse white matter disease increases the risk of developing cognitive impairment with aging. Vascular cognitive impairment tends to interfere with attention and the ability to plan, organize, and multi-task.
Acute ischemic damage can also provoke inflammation, swelling (edema), and other processes that can continue to cause damage for hours to days after the initial insult. In large ischemic strokes, the swelling can cause the pressure inside the skull to rise to dangerous levels.
Immediately after an ischemic stroke, the brain usually contains an irreversibly damaged core of tissue and an area of viable but at-risk tissue. Restoring normal blood flow—a process called reperfusion—is essential to rescuing the tissue that is still viable. The longer reperfusion is delayed, the more cells will die.
Hemorrhagic Stroke—In a healthy brain, neurons (brain cells) do not come into direct contact with blood. The blood-brain barrier, an elaborate meshwork of tightly fitting cells that form the inside layer of tiny blood vessels called capillaries, regulates which parts of the blood can pass through to the brain cells and what substances can pass into the bloodstream.
When an artery in the brain bursts, blood gushes into or around the brain, damaging the surrounding tissue. This is called a hemorrhagic stroke. The blood that enters the brain increases the pressure inside the skull (intracranial pressure) that can cause significant tissue damage. The mass of blood compresses the adjacent brain tissue, and the toxic substances in the blood mass further injure the brain tissue.
There are three types of hemorrhagic stroke, depending on where the bleeding occurs:
Conditions such as chronic high blood pressure (hypertension) and cerebral amyloid angiopathy (a buildup of the protein amyloid on the inside wall of blood vessels) can cause blood vessels to burst. Irregularities in the brain's vascular system (the network of arteries, veins, and smaller blood vessels) can also cause hemorrhagic stroke.
An aneurysm is a weak or thin spot on an artery wall. Over time, these weak spots stretch or balloon out. The thin walls of ballooning aneurysms can rupture, causing blood to gush into the space next to the brain and raise the intracranial pressure to dangerously high levels. Small cerebral aneurysms, less than three millimeters in diameter, are common. They usually do not cause symptoms unless there is a family history of bleeding aneurysms. The risk of bleeding is increased if there is a family history of bleeding aneurysms, or if the aneurysms are large (greater than seven millimeters in diameter). In those instances, neurosurgical or intra-arterial aneurysm repair is considered.
Arteriovenous malformations (AVMs) also increase the risk of hemorrhagic stroke. An AVM is an abnormal, snarled tangle of defective blood vessels within the brain that cause multiple irregular connections between the arteries and veins. The irregular connections allow arterial blood to travel directly to veins instead of first passing through a fine web of tiny capillaries. The blood flow through AVMs is exceedingly high and can cause the vessels to rupture.
In addition to a stroke, impaired blood supply through the brain's arteries and veins can cause venous infarctions, or areas of dead tissue.
Transient ischemic attack (TIA)—A transient ischemic attack (TIA) is a temporary cut-off of blood flow to the brain. A TIA occurs when blood flow to part of the brain is blocked, often by a clot, but then dissipates after a short time and the stroke symptoms go away. Any stroke damage from a TIA is typically temporary or confined to a very small region, but a TIA is an important warning sign that a larger, more serious stroke could come soon. An important type of TIA due to narrowing of the carotid artery is an occasional loss of vision in one eye.
A TIA—sometimes incorrectly referred to as a mini-stroke—starts just like any other stroke. Generally, the symptoms or deficits begin to disappear in less than 20 minutes, and often go away within an hour. However, these small strokes often indicate a high risk for a more serious stroke and an underlying condition that requires medical help. About one in three people who have a TIA will have a stroke sometime in the future, with the majority of those occurring within a year after the TIA. Additional factors increase a person's risk for a recurrent stroke. Because TIAs last for only a few minutes, many people mistakenly ignore them. However, taking action can save a life. Calling 911 as soon as symptoms appear can make the difference in avoiding lifelong disability.
Who is more likely to have a stroke?
Each year nearly 800,000 Americans have a stroke, and about 600,000 are first strokes. Once a person suffers a first stroke, the risk of another stroke increases. The risk of a recurrent stroke is greatest right after a stroke and decreases with time. In fact, about 25 percent of people who recover from their first stroke will have another stroke within five years, and approximately three percent of individuals with stroke will have another stroke within 30 days of their first stroke. Overall, one-third of recurrent strokes take place within two years of the first stroke.
Stroke occurs in all age groups, in both sexes, and in all races in every country. Stroke can even occur before birth, when the developing infant is still in the womb (a common cause of cerebral palsy).
Some risk factors for stroke apply only to females. These include pregnancy, childbirth, and menopause. These factors are tied to hormonal changes that affect females at different stages of life. In females of childbearing age, stroke risk is relatively low (with an annual incidence of one in 10,000). However, studies have shown that pregnancy increases that risk three times.
Several factors contribute to the increased risk of stroke during pregnancy:
In the same way that hormonal changes during pregnancy and childbirth are associated with increased stroke risk, hormonal changes at the end of childbearing years—during menopause—can also increase the risk of stroke. Although hormone replacement therapy (HRT) may help some symptoms of menopause, studies have shown that HRT increases the risk of stroke.
Children and stroke
Children have several unique stroke risk factors. The risk of stroke for children is actually highest during the perinatal period—which begins just before birth and ends a few weeks after. Males and Black children are at a higher risk for stroke than other groups.
Infants and children who have a stroke will experience symptoms that are similar to those in adults such as headache, hemiplegia (paralysis on one side of the body), and hemiparesis (weakness on one side of the body). However, children are more likely than adults to have other symptoms, including seizures, breathing problems, or loss of consciousness.
Risk factors for childhood stroke include congenital (present at birth) heart problems, head trauma, and blood-clotting disorders. An important risk factor for Black children is sickle cell anemia (a genetic blood disorder characterized by red blood cells that take on a sickle or crescent shape and block arteries). In addition to anemia, the disorder can cause joint pain, swollen spleen, frequent and severe infections, and narrowing of brain arteries.
The outcome of stroke in children is difficult to predict. A stroke during fetal development may lead to cerebral palsy. A stroke that occurs during infancy or childhood can also cause permanent disability. Generally, outcomes are worse in children under age one and in those who experience decreased consciousness or seizures.
Children who have a stroke generally recover better than adults after treatment and rehabilitation. This is due in part to the brain's plasticity, or its ability to reorganize, change, and adapt to deficits and injury, and to rewire itself to carry on necessary functions.
Risk factors of stroke. Some people are at a higher risk for stroke than others. Understanding the risk factors and working on them may help prevent a stroke. Generally, stroke risk factors fall into two categories: unmodifiable or modifiable.
Unmodifiable risk factors
Modifiable Risk Factors. Modifiable risk factors are those that can be changed or controlled to prevent or reduce the risk of stroke. The most important modifiable risk factors for stroke are high blood pressure, heart disease, diabetes, and smoking. Others include heavy alcohol use and high cholesterol. Stroke is preventable and treatable. A better understanding of the causes of stroke has helped people make lifestyle changes that have cut the stroke death rate nearly in half in the last two decades.
Simple steps can help people reduce their risk of stroke, cognitive impairment, dementia, and heart disease later in life:
Making lifestyle changes can reduce a person's risk of stroke. It is important for individuals to not stop taking their medications without first speaking with and getting approval from their healthcare provider. Stroke can be caused by people stopping their medications without medical guidance. The following are considered modifiable risk factors in preventing stroke:
How is stroke diagnosed and treated?
Diagnosing stroke. Doctors use several tools to help diagnose stroke quickly and accurately. The first step is a neurological examination, which is an observational evaluation of the nervous system. When a person suspected of having a stroke arrives at a hospital, a healthcare professional, usually a doctor or nurse, will carry out a detailed assessment of the person's signs and symptoms. They also will ask when the symptoms began. Because of the importance of early treatment, assessment might even begin in the ambulance.
One test that helps doctors judge the severity of a stroke is the standardized NIH Stroke Scale, developed through research supported by the National Institute of Neurological Disorders and Stroke (NINDS). Healthcare professionals use the NIH Stroke Scale to measure neurological function and deficits by asking the person to answer questions and perform several physical and mental tests. This checklist of questions and tasks scores a person's level of alertness and ability to communicate and perform simple movements. Other scales that may be used include the Glasgow Coma Scale, the Modified Rankin Scale, and the Barthel Index. These scales can sensitively measure disabilities that result from stroke.
Healthcare professionals also use a variety of brain imaging techniques to assess stroke risk, diagnose stroke, determine stroke type (and the extent and exact location of damage, and evaluate individuals for clinical studies and best treatment, including:
Although MRI and CT are equally accurate in determining when hemorrhage (bleeding) is present, MRI provides a more accurate and earlier diagnosis of ischemic stroke, especially for smaller strokes and transient ischemic attacks, or TIAs. Also, MRI can be more sensitive than CT for detecting other types of neurological disorders that mimic the symptoms of stroke. However, MRI cannot be performed in people with certain types of metallic or electronic implants, such as pacemakers.
Treating stroke. A stroke can cause permanent damage within minutes to hours. Calling 911 immediately and arriving at the hospital in an ambulance can aid in stroke treatment and recovery.
Treatment following a stroke generally falls into three therapeutic approaches:
Treatment for ischemic stroke or a transient ischemic attack may include medicines and medical procedures. Treatment for hemorrhagic stroke involves finding and controlling the cause of bleeding. Remarkable progress has been made in acute stroke therapy, especially with stenting and devices for clot removal to restore blood flow in brain arteries.
Treatments for ischemic stroke
Medication or drug therapy is the most common treatment for ischemic stroke. The most effective kinds of drugs to prevent or treat acute (occurring in the past few hours) ischemic stroke are antithrombotics (blood-thinning medicines which include antiplatelet agents and anticoagulants) and thrombolytics (drugs that break up and dissolve existing clots). Another group of medications—called neuroprotectants—protect the brain from secondary injury caused by stroke. Although there are no approved neuroprotectants for use in stroke, many medicines have been and are being tested in clinical trials.
Ischemic strokes can be treated by returning blood flow to the brain before the damage is complete—either by using intravenous thrombolytic drugs, which dissolve the blood clot that is blocking blood flow to the brain, or by placing a catheter into the blocked brain artery and removing the blockage. In all cases a person needs medical attention immediately after stroke symptoms start to be evaluated and receive treatment as fast as possible to preserve as much brain tissue as possible.
The body produces thrombolytic proteins, and some of these have been engineered into drugs. Decades ago, NINDS-funded research found that a thrombolytic drug known as t-PA (tissue plasminogen activator) can be effective if a person receives it intravenously (through a vein) within three hours after stroke symptoms have started. Study results showed that individuals who were given intravenous t-PA were 30 percent more likely to have minimal or no disability three months after treatment. This led to the first treatment approved by the U.S. Food and Drug Administration (FDA) for acute ischemic stroke. Since thrombolytic drugs can increase bleeding, t-PA should only be used after the doctor is certain that the person has suffered an ischemic, and not a hemorrhagic, stroke. In more recent studies, scientists have identified conditions in which individuals may benefit from t-PA beyond the three-hour window after stroke symptoms begin. Most clinicians now treat within a five hour window.
Additional NINDS-funded studies with key findings
Researchers have long been trying to determine if there is any benefit in giving antiplatelet drugs or anticoagulants during an ischemic stroke in addition to t-PA, or instead of t-PA (for people who are not eligible to receive t-PA). The purpose of one NINDS-sponsored trial—Trial of Org 10172 in Acute Stroke Treatment or TOAST—was to determine if stroke could be treated with a form of the anticoagulant drug heparin called Org 10172, which was less likely to cause bleeding. The study found that the drug produced no significant benefit. However, scientists were able to develop a set of guidelines—called the TOAST criteria—for defining different kinds of ischemic stroke. These guidelines now are widely used in other studies.
For many years, aspirin and warfarin were used to prevent stroke in people with atrial fibrillation—the most common heart condition that causes stroke. Researchers attempted to definitively determine if a daily regimen of aspirin or warfarin could benefit people at risk for ischemic stroke. Two NINDS studies showed that daily warfarin is best for people with atrial fibrillation who are over age 65 or who have additional risk factors. Results also showed that daily aspirin provides adequate protection against stroke among younger people (under age 60) with atrial fibrillation.
Two other NINDS-sponsored trials compared the effectiveness of daily warfarin and aspirin in people who did not have atrial fibrillation but who had experienced a prior stroke, and thus were at risk for another stroke. Both trials concluded that aspirin is equal to warfarin for reducing stroke risk in people without atrial fibrillation. A trial is now in progress to determine if anticoagulation with a direct thrombin inhibitor is more effective than antiplatelet therapy to prevent recurrent stroke in persons suspected of having atrial dysfunction.
Surgical and endovascular procedures
Brain blood vessels can be accessed by inserting catheters into large arteries in the leg and threaded into the brain blood vessels. This is the basis of catheter angiography, but it is also used to treat vascular abnormalities that cause stroke. Surgery can also be used to prevent or treat some types of stroke, or repair damage to the blood vessels, as well as to treat malformations in and around the brain.
Carotid endarterectomy involves surgical removal of obstructing plaque from the inside of a carotid artery which widens the artery. The carotid arteries, located in the neck, are the main suppliers of blood to the brain.
NINDS sponsored large clinical trials to test the effectiveness of carotid endarterectomy, which showed that carotid endarterectomy is safe and very effective in preventing stroke in people with carotid-associated TIAs and also somewhat effective for preventing stroke in most people without symptoms but who have more than 50 percent stenosis (narrowing of the carotid arteries). A NINDS-funded trial is now underway to examine the effectiveness of carotid endarterectomy in patients without symptoms of TIA or stroke who are taking aggressive stroke prevention medications.
Stenting involves inserting a catheter with a wire inside of it into the diseased artery and then passing a tube-shaped device made of a mesh-like material over the wire. The stent is compressed until it is threaded it into position, where it is then expanded to widen the artery and flatten the obstructing atherosclerotic plaque.
In the Carotid Revascularization vs. Stenting Trial (CREST)—a trial funded by NINDS—scientists compared endarterectomy with stenting. The findings showed that the overall safety and effectiveness of the two procedures was largely the same, with equal benefits for both females and males and for people who had previously had a stroke and for those who had not. However, the study showed that older people generally had a better outcome with surgery and younger people fared better with stenting.
In another NINDS study involving stenting, scientists compared the effectiveness of medical treatment plus stenting to medical treatment alone for the prevention of recurrent stroke in people who have severe stenosis of an intracranial artery. Results showed that aggressive medical treatment alone is better for preventing a second or recurrent stroke, and that stenting the intracranial artery increased a person's post-operative risk of developing a stroke or major bleeding from complications of the procedure.
Although the use of t-PA is the only medically proven treatment to dissolve a clot in patients with large arteries blocked by large clots, the drug does not open the vessel in time. To obtain reperfusion (normal blood flow) in such patients, specially trained neurointerventionalists thread a catheter (a thin, flexible tube) through the artery to the site of the blockage and use a variety of devices to open the artery. These include applying suction to vacuum out the clot. A corkscrew-like device can be extended from the tip of a catheter and used to grab the clot and pull it out. Several large, recent clinical studies have shown the benefit of stent-like devices to retrieve clot and return blood flow in people with large vessel occlusions (large clots in blood vessels) resulting in severe strokes. Severe strokes are those that can cause lifelong loss of independent functions and are often caused by blood clots that suddenly enter and block one of the main arteries that supply blood flow to the brain. A NINDS-funded trial showed that perfusion brain imaging using MRI or CT can identify some patients with large artery occlusion who benefit from clot retrieval up to 24 hours after stroke.
Recent advances in endovascular thrombectomy offer new opportunities to consider neuroprotective agents to extend the time window to restore blood flow to the brain, protect surrounding tissue, and improve long-term functional outcome. Studies planned through the NIH Stroke Preclinical Assessment Network will determine if an add-on intervention can improve outcome compared to restoring blood flow alone and lead to clinical trials using the most promising neuroprotective therapies.
Treatments for hemorrhagic stroke. Treatment for hemorrhagic stroke involves finding the source of the blood leak and controlling it. Hemorrhagic strokes get worse with thrombolytic medications, making it important to determine the major stroke type before starting emergency treatment.
Aneurysmal subarachnoid hemorrhage
Bleeding from a ruptured cerebral aneurysm (subarachnoid hemorrhage) causes a severe headache that comes with a split-second onset. It may cause immediate loss of consciousness, but some people only experience the thunderclap headache. Survivors are at high risk for re-rupture of an aneurysm, so they desperately need emergency care. It is critically important to treat an aneurysm that has ruptured as recurrent bleeding is almost always fatal.
One surgical procedure for treatment of brain aneurysms is a technique called "clipping." Clipping involves an operation during which an experienced neurosurgeon places a clamp on the aneurysm neck to prevent the chance that it will burst, often providing a cure.
The endovascular coil technique (also known as endovascular embolization) also treats high-risk cerebral aneurysms. A small detachable platinum coil is inserted through an artery in the thigh and threaded through the vessel to the site of the aneurysm. The coil is then released into the aneurysm, where it triggers clotting and an immune response from the body. This immune response strengthens the artery walls and reduces the risk of rupture.
In cases where the aneurysm is not amenable to clipping or coiling and there is a high risk of hemorrhage, it may be necessary to occlude (close or block off) the artery feeding the aneurysm.
These procedures are used to treat aneurysms that have ruptured, as well as large aneurysms in individuals with no symptoms (asymptomatic) and small aneurysms in someone with a prior aneurysmal bleed or a family history of aneurysmal bleeding. Treatment in asymptomatic individuals with smaller aneurysms and without a history of rupture is more controversial.
Patients with a ruptured cerebral aneurysm require intensive care. They are at high risk of developing a widespread narrowing, or vasospasm, of brain blood vessels in the ensuing two weeks due to the irritating effects of the blood. Vasospasm can cause ischemic brain injury and is managed by medical and endovascular treatments. Such patients also frequently have blood clots blocking the flow of cerebrospinal fluid in the brain, causing a buildup of pressure inside the head that requires inserting a shunt catheter into the fluid-filled cavities in the brain (ventricles) to divert the flow of fluid. CT scanning can monitor the degree of enlargement of the ventricles, called hydrocephalus.
The most common hemorrhagic stroke subtype is intracerebral hemorrhage (ICH), which is caused by years of high blood pressure that weakens a small artery in deep brain regions. Multiple clinical trials of emergency surgery to remove the clot have not confirmed benefit. Intensive care medical treatment of hydrocephalus and brain edema (swelling) is critical in the acute period and during rehabilitation. In some patients the blood is primarily in the fluid-filled ventricles of the brain, but the clots frequently block the flow of cerebrospinal fluid—leading to hydrocephalus. Inserting a ventricular shunt to drain the blood and manage hydrocephalus is essential in these cases.
Rehabilitation. Rehabilitation is vital to stroke recovery. Stroke is the number one cause of serious adult disability in the U.S. and worldwide, but most people with stroke have some recovery of function. Ongoing research in this area has developed several potential approaches and therapies to help rehabilitate people after stroke.
What are the latest updates on stroke?
The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health (NIH), a leading supporter of biomedical research in the world.
The Institute sponsors a wide range of basic and clinical research aimed at finding better ways to prevent, diagnose, and treat stroke, and to restore functions lost due to stroke. NINDS scientists conduct stroke research in the Institute's laboratories and clinics on the NIH campus in Bethesda, Maryland, and in two Washington, D.C. area hospitals. NINDS also funds and supports stroke research at universities, medical schools, and hospitals located across the country and the world.
Basic research helps scientists gain new knowledge and increase their understanding of stroke. This research creates the foundation for diagnosing and treating stroke. Clinical research, which makes up a large portion of stroke research, gives scientists a way to test new treatments for people—including surgical devices, procedures, medications, and rehabilitation therapies. The overall goal of stroke research is to translate basic research findings into useful therapies and effective interventions for people with stroke.
NINDS-supported scientists are working to develop new and more effective treatments for stroke, discover ways to restore blood flow to the brain after stroke, and protect brain cells from dying after stroke. Scientists also are looking at ways to improve rehabilitation and post-stroke recovery and learn more about the risk factors for stroke in an effort to discover new methods of stroke prevention. Also, researchers are using imaging techniques to learn more about how stroke affects the brain and which stroke treatments might be effective.
NIH StrokeNet. NINDS created a stroke clinical trials network that serves as the infrastructure and pipeline for exploring new potential treatments for people with stroke and those at risk for stroke. The NIH StrokeNet, which is a centralized coordinating and data management center with 29 regional centers that are linked to nearly 400 stroke hospitals across the U.S., conducts small and large clinical trials and research studies to advance acute stroke treatment, prevention, and recovery and rehabilitation following a stroke.
The NINDS-funded DEFUSE 3 trial, which was conducted through StrokeNet, used advanced techniques of brain imaging to identify individuals who still might benefit from thrombectomy after its traditional six-hour window of use from stroke onset. This trial successfully demonstrated that physically removing brain clots for up to 16 hours after symptom onset in selected individuals led to improved outcomes compared to standard medical therapy. Advanced brain imaging helped identify which patients could benefit from restoring blood flow beyond standard treatment times.
More Effective Treatments. NINDS-funded research has a rich history involving medications to treat stroke, including the first approved drug to treat ischemic stroke—t-PA, or tissue plasminogen activator—and the finding that aspirin is just as effective as a medication called warfarin for preventing additional strokes. Researchers now hope to discover more effective medications, and to continue building on the clot-busting success of t-PA.
Current NINDS-funded stroke research includes:
How can I or my loved one help improve care for people who have had a stroke?
Consider participating in a clinical trial so clinicians and scientists can learn more about stroke and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.
All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.
Where can I find more information about stroke?
Information may be available from the following organizations and resources:
American Stroke Association
Brain Aneurysm Foundation
Phone: 781-826-5556 or 888-272-4602
Child Neurology Foundation
Children's Hemiplegia and Stroke Association
Fibromuscular Dysplasia Society of America
Phone: 216-834-2410 or 888-709-7089
Heart Rhythm Society
Joe Niekro Foundation
National Aphasia Association
Phone: 212-267-2814 or 800-922-4622
Phone: 843-248-9019 or 843-655-2835
Content source: https://www.ninds.nih.gov/health-information/disorders/stroke Accessed July 17, 2023.
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