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URMC » Quality » Ratings » Stroke

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• Quality Measures
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  • Stroke
    • Overview
    • Around-the-clock brain imaging
    • Around-the-clock radiologist available to interpret brain imaging studies
    • Stroke disease management program: Availability and type
    • Use of tPA for stroke
    • Board certification of neurologists
    • Patient and community education
    • Inpatient mortality for stroke patients
    • Average length of stay for stroke patients
    • Comprehensive stroke center
    • Stroke rehabilitation program
    • Aspirin administration within 48 hours from onset of stroke
    • Antithrombotic medication prescribed at discharge for stroke patients
    • Vascular neurologist availability
• Glossary of Terms

 

Use of tPA for Stroke

Strong Memorial Hospital uses tPA to treat ischemic stroke patients when appropriate, according to national guidelines.

Stroke occurs when blood flow to the brain is disrupted. Disruption in blood flow is caused when either a blood clot or piece of plaque blocks one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke) (Neurology, 2005; 64: E1-E2).

Intravenous tissue plasminogen activator, or tPA, (also known as a "clot-buster" medication) is currently the only agent approved by the U.S. Food and Drug Administration (FDA) for treating acute ischemic stroke. tPA should be administered within three hours of onset of acute ischemic stroke in patients who meet certain eligibility requirements (New England Journal of Medicine, September 7, 2000: 343(10); 712-722).

Nationwide, 10 to 20% of eligible ischemic stroke patients receive tPA (Stroke, November 2005: 36(11); 2500-2503).

tPA is not generally used for hemorrhagic stroke or in those who may experience bleeding problems because it may increase bleeding. A CT scan or MRI of the brain is needed to quickly determine if an individual is having an ischemic or hemorrhagic stroke.

The pooled results of three major tPA trials confirmed that early stroke treatment is strongly associated with favorable stroke outcomes (The Lancet, March 6, 2004: 363(9411); 768-74).