THURSDAY, Oct. 6, 2005 (HealthDay News) -- Some stroke patients who are eligible to receive a powerful clot-busting drug don't get it because they have mild or dissipating stroke symptoms.
But a new study finds that many of these patients do go on to suffer serious disability problems.
The drug, tissue plasminogen activator (tPA), breaks up blood clots in the brain and helps reduce permanent disability. But tPA can also cause bleeding in the brain, so it is used with caution.
The study of 431 ischemic stroke patients focused on 41 who were deemed to have milder symptoms that made them "too good to treat" with tPA. However, the researchers also noted that 11 of these patients (27 percent) couldn't be discharged home because of the severity of their post-stroke disability. They stressed that it can be difficult for doctors to decide whether to give a stroke patient tPA.
"Physicians may think that some patients who have mild or improving stroke symptoms shouldn't be given tPA because of the bleeding risks associated with it; however, these patients may still be at risk for post-stroke disability," researcher Dr. Eric E. Smith, instructor of neurology at Harvard Medical School and Massachusetts General Hospital, said in a prepared statement.
His team published its findings in the current issue of the journal Stroke.
"We need some large, multi-center studies to find out any significant predictors of short-term outcomes after patients have been excluded from tPA because of mild or improving stroke," Smith said.
Previous studies have suggested that as many as 43 percent of stroke patients who are eligible for tPA do not receive the drug solely because these patients have mild or improving stroke symptoms.
In another study in the same issue of Stroke, German researchers compared outcome and severe bleeding among 228 ischemic stroke patients aged 80 and older. The researchers noted that a presumed increased risk of brain bleeding is often cited as the reason for not using clot-busting drugs in elderly stroke patients.
This study found that while stroke patients aged 80 and older had worse outcomes than younger patients, they did not face any increased risk of brain bleeding when treated with clot-busters.
"The number of very old acute stroke patients will increase dramatically and it appears unjustifiable to exclude this increasing patient population a priori from the only approved and effective treatment of acute ischemic stroke," wrote researchers at Universitatsklinikum Hamburg-Eppendorf in Hamburg.
More information
The U.S. National Library of Medicine has more about tPA.
