A clot-busting drug, Thrombolysis, is now a vital tool in the treatment of stroke. But a Gwent stroke expert is warning that many patients are being deprived of its benefits because they do not get to hospital early enough.

LIKE the treatment of cardiac arrest, the earlier a victim of stroke can be treated, the better the chance of a good outcome.

A key weapon in combating the effects of stroke, which affects more than 100,000 people a year in the UK, is thrombolysis.

This involves the administering of a clot-busting drug intravenously, to try to minimise the potential damage to the brain.

While it isn’t suitable for everyone, thrombolysis can be a lifesaver, and can make a significant difference to recovery.

As lead stroke physician at the Royal Gwent Hospital, Dr Yaqoob Bhat is involved in the treatment and care of hundreds of patients a year, and sees regularly the benefits of early intervention with thrombolysis.

But he is worried that a lack of public awareness of stroke generally, and of this treatment in particular, means patients who might otherwise benefit from it, are arriving too late to receive it.

“People are, on the whole, coming to the right place when they have a stroke – but they are not coming early enough,” he said.

“A lot of people ignore the symptoms of stroke and think it will go away, so although they do come up here (to the Royal Gwent’s stroke unit), they don’t come in time.”

Thrombolysis has to be administered within four-and-a-half hours of a stroke, but the earlier the better, and evidence suggests that recovery is much better if treatment is given inside two hours.

Dr Bhat believes there needs to be a bigger awareness of stroke and its treatment among the public, and that the media has a key role to play.

“Stroke causes more disbility than any other disease. Although heart attacks are high in this respect too, there is nowhere near the comparison, but they are not dealt with in the same way by the media and by public health bodies,”

he said. “We are achieving thrombolysis for four to five per cent of patients who are eligible and it should be ten per cent.

“We did achieve that for three months or so, but it has tailed off again. What we need is regular awareness through the media, because when stories have appeared in the Argus and other newspapers, there has been an increase in awareness and in patients coming in more quickly, and they have said they have read about it in the paper.”

That four to five per cent thrombolysis rate in Gwent equates to 50- 55 patients a year, but Dr Bhat said the figure should be at least double that.

There are around 11,000 strokes in Wales every year, and currently more than 65,000 people here living with the effects of stroke.

People with strokes involving haemorrhage are not eligible, and thrombolysis is not always an appropriate treatment for all patients with strokes caused by clots. As well as the time factor, reasons for ineligibility include age - whether too young (under 18) or too old (over 80) - recent major surgery, or another stroke or head injury in the past three months.

“But we could treat more, and if we save one disability we also potentially save a great deal of money in terms of recovery and care for that patient, often over many years,” said Dr Bhat.

FAST test for stroke diagnosis

THE most recent high profile awareness campaign around stroke was called FAST, which is still promoted as a means of recognising the symptoms in a person. It involves the FAST test:

FACIAL WEAKNESS: Can the person smile? Has their mouth or eye drooped?

ARM WEAKNESS: Can the person raise both arms?

SPEECH PROBLEMS: Can the person speak clearly and understand what you say?

TIME TO CALL 999.

If a person fails any of the tests, 999 should be called immediately.

The Stroke Association, the UK’s leading stroke charity, has a website packed with useful information on stroke - including symptoms - and contacts. It is at www.stroke.org.uk

The charity also runs a helpline for people who want to talk about stroke and its effects – 0303 3033 100.