Stroke Of Luck

By David Bjerklie

Every 45 seconds, someone in America has a stroke; every three minutes, someone dies of one. That translates into 700,000 strokes and 165,000 deaths each year, making ischemia (the technical term for the most common type of stroke) the nation's No. 3 killer. Even among survivors, strokes can exact a terrible toll: aftereffects range from difficulty walking, speaking and carrying out the everyday activities of life to depression and paralysis.

The key to treatment is speed. As the American Stroke Association's slogan puts it: "Time lost is brain lost." The clot-busting drug TPA, for example, has to be delivered within a critical treatment window that closes about three hours after symptoms first appear. The most exciting research presented at the 29th International Stroke Conference in San Diego last week was advances aimed at opening that window a little wider. Among them:

COOLER HEADS Researchers know lower temperatures protect the brain from injury, but cooling the brain usually cools the rest of the body as well, including the heart and immune system. A Japanese study presented last week reported that a helmet using a liquid-cooling technology developed by NASA and designed to cool only the head shows great promise as a way to reduce the severity of neural damage. The researchers hope such a helmet may someday be used by emergency personnel to slow the progression of a stroke and lengthen the time a patient is eligible for clot-busting therapy.

VAMPIRE BATS There's a chemical in the saliva of blood-sucking bats that resists clotting and helps keep a victim's blood flowing. The same chemical can be used to dissolve clots, and researchers have developed a synthetic version of the compound that's so effective it can extend the time window for treatment in some patients from three hours to as many as nine.

The corkscrew The most direct approach to fighting stroke is to break up the blood clot that is causing it; the risk is that the clot will break into smaller particles that then lodge deeper in the brain. At the meeting last week, researchers reported that a tiny corkscrew device, housed in a thin catheter, can snag clots and pull them out without disrupting them--stopping the stroke damage almost instantly. The mechanical embolus removal in cerebral ischemia (MERCI) system restored blood flow in 54% of patients as long as eight hours after initial stroke symptoms appeared.

The best treatment of all, of course, is to prevent strokes from happening in the first place. The steps doctors recommend are pretty straightforward. If you have high blood pressure, reduce it. If your cholesterol level is high, lower it. If you smoke, stop. If you drink, do it moderately. If you're overweight, reduce. And if you are sedentary, exercise.

Sound hard? Look at it this way: if you do these things to reduce your risk of stroke, you'll also reduce your risk of a heart attack.