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Considering the plight of most people in her situation, Becky Hemingway was faring well. Her right side had gone numb, and she couldn’t speak. But her family had immediately suspected a stroke, and emergency room physicians at a hospital in South-bridge, Mass., not only made the diagnosis but also rushed the 31-year-old new mother to a regional stroke center in Boston, two hours to the east, where she could receive specialized care.
In contrast, the average stroke victim doesn’t get treated for almost a day, though the only approved current drug therapy must begin within three hours. Nine out of 10 strokes are ischemic, resulting from blood clots that cut off the oxygen supply to brain tissue, and the drug—tissue plasminogen activator, or TPA—dissolves clots. Given too late, however, TPA can further weaken blood vessels in the brain, increasing the risk of a potentially fatal hemorrhage. What’s worse, medical researchers have recently concluded that TPA itself might be toxic to some brain cells. Because of such risks, most physicians are reluctant to administer TPA even within the three-hour window. And the 3 percent of patients who receive the drug on time have a less than even chance of a positive outcome.
So stroke remains a prodigious killer, taking 165,000 lives annually in the U.S. (Only heart attacks and cancer are deadlier.) Another 535,000 stroke victims survive each year, but many have lifelong disabilities—ranging from complete paralysis and cognitive dysfunction to impaired speech. That makes stroke one of the nation’s most expensive diseases, costing an estimated $57 billion a year.
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