tPA and MRI for Stroke: Were You Properly Treated?

Nurse Assessing Stroke Victim

Should you or a loved on have received a tPA and MRI for stroke symptoms? Stroke is the third leading cause of death, and the primary cause of permanent disability in this country. A stroke can occur without warning and devastate your ability to speak, move, and care for yourself. In recent years, in an effort to ameliorate the effects of stroke, public education efforts have focused on recognizing the signs of a stroke so that you can seek treatment sooner. It is well-known that the sooner you are treated, especially if you receive treatment within the so-called "golden hour" soon after symptoms appear, you are much more likely to survive and avoid long-term brain damage.

Successful treatment, of course, goes hand-in-hand with prompt and accurate diagnosis. If you present to the ER with stroke symptoms, and the physicians there fail to use the appropriate diagnostic tools, you could be at risk of delayed diagnosis and delayed treatment. Let's take a look at some of the recommended diagnostic and treatment tools for stroke, including acute ischemic stroke, which accounts for the great majority of the 750,000 stroke cases in the United States each year.

Should You Have Had an MRI for Stroke Symptoms?

Ischemic strokes are caused by a lack of blood flow in the brain. For many years, CT scans were the standard test performed on patients to diagnose stroke. Several years ago, however, the American Academy of Neurologists (AAN) updated its guideline to reflect the finding that magnetic resonance imaging (MRI) scans are superior to CT scans when it comes to detecting damage from ischemic stroke.

The AAN guideline indicated that the MRI was preferable for diagnosing acute ischemic stroke within the first twelve hours of the appearance of symptoms. The AAN reviewed a number of large studies in formulating the guideline, one of which reported that MRI accurately detected stroke 83 percent of the time, in contrast with the 26 percent detection rate by CT.

None of this is to say that CT scans don't have utility for stroke detection, and there may be a valid reason that your medical team chose a CT for you over an MRI. However, if the CT failed to detect your stroke, or the severity of the damage, you may not have received the best treatment or received it as promptly as you should have. This, of course, might have resulted in more severe or permanent damage, and a longer recovery from the damage that could be successfully treated.

Should You Have Received tPA in the ER?

One advantage in getting to the hospital within the "golden hour" is that you may be able to be administered a medicine called tissue plasminogen activator, or tPA. This medication is used to treat strokes within the first three hours following symptom onset, and if it is administered in a timely fashion, one out of three patients who receive it resolve their stroke symptoms entirely or have significant improvement.

tPA is used to treat ischemic strokes, which are caused by blood clots. Because it is a "clot-busting" drug, it is not only ineffective, but dangerous, for use in hemorrhagic strokes, which are caused by a blood vessel bleeding into the brain. You can see that a medical team's failure to promptly and correctly diagnose an ischemic stroke might lead to a delay in the administration of tPA, or the inability to administer it at all. The benefit of tPA appears to drop off significantly after three hours from the onset of symptoms, and there may be a small increased chance of harmful effects, such as hemorrhage, when the treatment is given too late.

If you were not given tPA when you presented at the hospital with stroke symptoms, that doesn't necessarily mean that medical malpractice was involved. Each patient is different, and your medical care team may have had very good reasons for the treatment choices they made. However, it is worth investigating why you were not administered this potentially helpful treatment, especially if your examination and reported symptoms indicated treatment with tPA was appropriate.

If you have suffered a stroke, and believe that the emergency room staff or stroke treatment team failed to follow protocols that could have reduced your injury or recovery time, you may want to discuss your situation with an experienced Oregon medical malpractice attorney. An attorney who handles a significant number of medical malpractice cases involving stroke will have the background to help you determine whether you have a claim worth pursuing.

Recovery from stroke can be long and difficult. Nothing can make up for what you've suffered, but if you have a medical malpractice claim with merit, you may at least be able to get compensation that will allow you to focus on your physical recovery rather than financial worries.

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Categories: Medical Malpractice