What is the First Line Treatment of Stroke

There is no time at all to waste when it comes to stroke. The additional time that passes in between stroke attack and treatment, the worse the result is for the sufferer. A study developed to examine the advantages of early administration of magnesium sulfate recommends that stroke sufferers may not have to wait till they get to the medical center for treatment — paramedics may be capable to begin therapy as quickly as stroke is suspected. Even though the drug did not enhance outcome in stroke sufferers, the research proved the feasibility of early treatment in the ambulance. The outcomes were presented in the New England Journal of Medicine and the research was financed by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.

Walter Koroshetz acting doctor of NINDS stated “This study reveals that it is feasible to get therapies to stroke sufferers prior to they reach at a hospital. Because an obstructed blood vessel leads to brain destruction over minutes to hours this pre-hospital method to therapy is sure to be implemented and refined in upcoming clinical research studies. Ultra-early brain salvage in stroke sufferers will someday definitely decrease the tremendous burden of impairment and death because of stroke”.

Jeffrey Saver, M.D., director of the University of California and his team designed a new method to performing a stroke clinical trial. They wished to know if it was feasible to reduce the time between stroke attack and therapy by having paramedics administer stroke treatments as early as stroke is assumed. In most stroke studies, sufferers seem to obtain preliminary therapy after going through tests at a medical center, which may be take more than an hour after the stroke started.

The Field Administration of Stroke Therapy-Magnesium (FAST-MAG) Phase III study was a multi-center, randomized, placebo-controlled clinical research. In this research, 1700 sufferers who were assumed of having had a stroke were provided magnesium sulfate or a placebo by paramedics within couple hours of stroke attack.

Paramedics applied a model of the Los Angeles Prehospital Stroke Screen designed by the Researchers to quickly and effectively recognize potential stroke sufferers. Paramedics then approached a neurologist via phone to additional identify if a sufferer should be involved in the study. After this approach, the sufferers or their associates gave permission to the study physician to take part in the study.

This trial suggested that sufferers were capable to obtain a study drug faster than in other stroke studies. Investigation unveiled that 74.3% of sufferers obtained a study intervention inside 1 hour of stroke attack.

Lead author Dr. Saver said “The very essential finding of this trial was that drugs could be provided within the ‘golden hour’ of 1st onset of stroke symptoms when there is the best amount of brain to save. That indicates the pre-hospital paramedic delivery of drug system that was designed in FASTMAG could turn out to be a platform for examining more drugs and devices in the future.”

In add-on to examining the new protocol, the investigators wished to see if a specific drug, magnesium sulfate, assisted enhance results in sufferers 3 months after stroke. Magnesium sulfate has been proven to present neuro-protective effects in animal models of stroke.

When the scientists examined the drug outcomes, they identified that magnesium sulfate was not superior than placebo at decreasing disability following stroke.

“However the drug we examined been found to be ineffective, but now there are a lot of ensuring medicines and medical devices in the pipeline that can be used with this new protocol and the study has showed a new window in which the treatments are most probably to be successful. There are various studies ongoing that are taking elements of the FASTMAG foundation and applying it to examine ensuring agents for neuroprotection.”

Adding to above statement Co- Principle Investigator Dr. Sidney said “We feel this research shows a model shift in the therapy of stroke and possibly many other neurological problems.” We have never performed something this huge that shows that paramedics not only are eager to offer the ideal possible patient care, but also are able of being crucial partners in an intense, time-dependent clinical study.