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Editor: Robert Blanchard
Profession: Attorney at Law

Category: Ortho Evra Medical Information

Ortho Evra users may be able to benefit from the latest treatments.
Each year, about 700,000 people in the United States suffer a stroke, according to the American Stroke Association. It is the third leading cause of death in the country, after heart disease and cancer, claiming 157,000 lives a year.
A stroke occurs when blood flow to the brain is blocked either by a blood clot or the bursting of a blood vessel. This event deprives the brain of oxygen and nutrition, causing the affected part to die. For every second that a stroke goes untreated, 32,000 brain cells die -- nearly 2 million a minute. Depending on the severity of the damage and which part of the brain is affected, a stroke can cause paralysis, vision problems, behavioral changes, speech problems and memory loss.
The good news is that several treatments greatly reduce the damage a stroke can inflict on the human brain. The bad news is that a lot of people don't get to the hospital early enough for therapies to be administered. One therapy, the popular clot buster known as Tissue Plasminogen Activator, or tPA, must be administered within the first three hours for a stroke to be effective.

Recently, several other therapies have been developed, according to Dr. Paul Katz, medical director of the Washoe Institute for Neurosciences and the Comprehensive Stroke Center. Intra-arterial thrombolytic therapy, which uses a catheter to go directly to the clot and administer a clot-busting drug, can be done up to six hours after a stroke. There's also a new clot retrieval device that can be used to yank a clot out; the treatment can be administered up to eight hours after the onset of stroke. Meanwhile, clinical trials are under way for a new agent that can be administered up to nine hours after a stroke.

"These are truly miraculous therapies," said Selinda Shontz, senior director of State Health Alliances and Stroke Programs for the American Heart Association's Western states affiliate. "But if you don't have stroke awareness in the community and people don't recognize the warning signs ... then it doesn't matter what treatment is available because patients don't get there in time."

In the United States, only 3 percent to 5 percent of stroke victims reach the hospital in time to be considered for tPA. The number is higher in Nevada, where 10 percent of patients get some sort of early stroke treatment.

Katz credits aggressive efforts to educate emergency medical services personnel and get rural hospitals involved. Donahue, for example, was administered tPA in Banner Churchill Community Hospital in Fallon, where the doctor was walked through the process by phone. Still, the numbers could be better, Katz said. Lack of awareness among the public remains the biggest hurdle in improving early treatment numbers, experts agreed.

"If you look at prototype centers in Cleveland, Cincinnati, San Diego and Houston, (their stroke interventional therapy rate) is up to about 20 percent," Katz said. "We have been making inroads, but raising public awareness about stroke still remains as the main challenge."