Every year in the United States, nearly 680,000 people experience the
most common form of stroke called ischemic stroke. This occurs when a
blood clot restricts blood flow to the brain. For anyone having a
stroke, the faster normal blood flow in the brain can be restored, the
more likely it is that person will regain a normal life.
For the last two decades, most doctors believed they had only three
hours after a stroke to deliver effective treatment. The work of
neurologists, neurosurgeons and interventional neuroradiologists at
Stroke Center, however, has changed this thinking and vastly
improved the odds of a full recovery.
New brain imaging techniques and minimally invasive treatments
pioneered by these doctors now give stroke patients treated at
Stanford a much better chance to return to their normal lives after a stroke.
These advances save mobility and function by:
Providing a precise, real-time view of what is happening
inside each patient’s brain so doctors can quickly assess which
parts of the brain have been affected and then deliver more
effective, individualized treatment
Expanding the usefulness of stroke treatment long beyond the
time limit once thought possible
Providing new options for treatment to bring hope to patients
once considered untreatable
The Stanford Stroke Center has pioneered the use of brain imaging
that is changing the way doctors treat stroke.
neurologist Greg Albers and his colleagues at the Stanford
Stroke Center have long been at the forefront of developing advanced
brain imaging and image processing techniques. These techniques are
used to examine the brain of each stroke patient at Stanford.
Their most recent imaging advance is a unique software program
called RAPID that uses data from MRI and CT scans to track blood flow
in the brain. This new imaging platform:
provides an accurate view of the parts of the brain that have
been irreversibly damaged and the parts that can still be saved
beyond the standard three-hour treatment window.
allows doctors to devise individualized treatment options
based on each patient’s physiological condition, rather than
automatically following a standard treatment protocol.
Ongoing Research to Extend the Treatment Window
Dr. Albers and his research group have also used the new RAPID
imaging technology to upend conventional thinking and show that there
is wide variability in how stroke affects the brain. Their findings
- Some people’s brains will more easily compensate for loss of
blood flow to particular areas. This variation means that for some
patients, three hours after a stroke is already too late for
- For others, the treatment window can
extend up to 12 hours or longer. Stanford is now leading a large
multi-center clinical trial to test whether that window might be as
long as 16 hours.
For 20 years, the gold standard for stroke treatment has been a
clot-dissolving medicine called tPA — tissue plasminogen activator.
This substance can often restore blood flow if clots are small and the
medication is given early, however, it has limited success for large clots.
Six of 10 patients do not respond to tPA, so other treatment options
have been developed. Some stroke patients have been helped by a
catheter-based treatment that sends tiny mechanical devices into the
brain to physically remove the clot.
Stent Retriever: An Important New Option for Stroke Care
Stanford’s stroke doctors were among the first in the United States
to test the next-generation solution called a stent retriever. The
stent retriever has shown it can unblock blood vessels affected by
stroke up to six hours afterwards.
The Stanford Stroke Center was the first hospital in Northern
California to combine the stent retriever and patient selection
strategies for regular clinical use.
Recent studies that combined the new Stanford imaging techniques and
the stent retriever reported the best outcomes ever achieved for
treatment of stroke-- favorable outcome rates as high as 71%.