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Twenty years ago, a stroke wasn't considered an emergency. No treatment to reverse or limit a stroke's brain damage.
In 1996, the clot-busting drug tissue plasminogen activator was approved to treat strokes. That also caused a great deal of rethinking how health care providers responded to strokes. What was not an emergency suddenly became one. That meant a lot of rethinking of roles and actions of health professionals when a stroke happens.
An interesting take on that history and more ideas evolving, focusing on when stroke care is a statewide effort:
The stroke system of care concept has evolved over the past 15 years because of advances in treatment. Before federal approval of tPA in 1996, no treatment existed to reverse or limit a stroke’s damage to the brain, says Michael Frankel, M.D., chief of neurology and director of the Marcus Stroke & Neuroscience Center at Grady Memorial Hospital, Atlanta.
“Stroke was not considered a neurological emergency,” Frankel says. “It sounds stupid to even say that today, but there was no proof that anything we did helped people. We didn’t have the sense of urgency to bring people in quickly, to assess them quickly, to save the brain and, therefore, improve outcomes.”
Approval of tPA was the very beginning of the stroke system of care story, Frankel says. The CDC’s creation of the Coverdell program in 2001 helped to move things along.
Georgia was one of the first states to receive federal funding and, from the outset, its stroke registry was more than a disease surveillance program. It harnessed stroke data to drive change.More treatments - drugs and devices and more - are becoming part of stroke treatment. So we can't stop thinking about ways to improve. It's far too important.