May is Stroke Awareness Month—a good opportunity to reflect on the progress we have made in stroke prevention and treatment and also think about challenges and opportunities. Along these lines, I was invited to contribute an article to Scientific American taking a bird’s-eye view of the current state of stroke research and treatment. I will share some highlights here, and I invite you to read more about not just where we are, but how we got here and where we still need to go: We've Made Astonishing Progress in Treating Stroke.
Stroke has fallen from the nation’s third leading cause of death to the fifth, as better management of cardiovascular risk factors, greater awareness of symptoms, and prompt, more effective medical attention are helping to prevent strokes and improve outcomes. These changes are encouraging, but several hundred thousand new strokes occur each year and millions of people currently suffer disabilities from stroke. Therefore, stroke remains a major priority in the NINDS research portfolio.
Ischemic strokes, caused by clots in brain arteries that block blood flow, are the most common type of stroke in the US. NINDS research was critical to the development of t-PA (recombinant tissue plasminogen activator) therapy to restore blood flow in acute ischemic stroke, becoming the first FDA-approved treatment in 1996. Another exciting development then followed: endovascular thrombectomy, or the physical removal of blockages that lead to stroke, was shown in 2015 to be more effective than tPA alone for restoring blood flow in patients with strokes caused by clots in large brain blood vessels. Over the past two years, neuroimaging advances pioneered by NINDS-supported investigators have allowed us to identify stroke patients who may benefit from these treatments. In every case, the earlier a stroke is treated, more brain tissue can be saved, and the better the patient’s outcomes. However, the neuroimaging can identify a subset of patients who still show some benefit from treatment at longer times after stroke onset than once thought possible, sometimes even up to 16 hours after stroke onset.
NINDS continues to support research in all aspects of stroke, including prevention, treatment, and recovery. Through StrokeNet, NINDS is making clinical studies faster and more efficient by linking up a nationwide network of hospitals to pool their resources and expertise. A number of our most recent advances in treating stroke have come out of this network and have had an immediate impact on clinical care. We are also increasing understanding about stroke through public outreach and engagement. Our long-running KnowStroke campaign is teaching the public how to recognize symptoms of stroke and view stroke as an emergency requiring immediate treatment. Our newest campaign, MindYourRisks, is spreading the message that controlling high blood pressure can lower the risk of not just stroke and heart attack, but also dementia.
I am also delighted to there will be a Facebook Live event about stroke awareness on Tuesday, May 28, 2019 at 1:00 pm (Eastern Time). NINDS will be joined by representatives from our partners, the American Stroke Association and the American Academy of Neurology, and together we hope to bring our message to thousands of people. Be sure to tune in and send us your questions. For more information about this event, please visit https://www.facebook.com/NINDSBrainForLife/.