Tissue Plasminogen Activator

If you or someone you love has suffered a stroke after a vertebral arterial dissection, it’s important to get treatment as quickly as possible. The medical community has found that the faster a patient receives appropriate treatment, the better their long-term outcome is.

The most commonly used thrombolytic medication approved for treatment of stroke is Tissue Plasminogen Activator (tPA). Thrombolytic therapy works by dissolving blood clots, which are the cause of stroke associated with arterial dissection. The medication is delivered through an intravenous line (IV) or catheter.

Strokes, Long-term Disability, and Death

According to the 2016 Heart Disease and Stroke Statistics Update, strokes kill nearly 130,000 people a year. That’s a death every four minutes. Strokes are also the leading cause of long-term disability and the leading preventable cause of disability. Ischemic strokes (a result of an obstruction within a blood vessel supplying blood to the brain, which is what can occur after an arterial dissection) account for approximately 85 percent of all stroke cases and are caused when blood clots move to a blood vessel in the brain blocking blood flow to that area. If administered within 3 hours, tPA can improve the chances of recovering from a stroke significantly.

Exam Prior to Treatment

Prior to administering tPA for an ischemic stroke, several things will be considered, such as: medical history, age, and gender. A physical exam to diagnose a significant stroke and a brain CT scan to confirm there has not been any bleeding, will be performed as well.
You may not be a candidate for tPA if any of the following medical conditions exists:

• Head injury
• A history of bleeding problems
• Bleeding ulcers
• Pregnancy
• Recent surgery
• Taking blood thinning medications
• Recent trauma
• Uncontrolled high blood pressure

Risks and Side Effects

Hemorrhage (bleeding) is the most common risk for both heart attack and stroke patients. Bleeding into the brain happens approximately 1% of the time. Some minor bleeding from the nose or gums occurs in about 25% of the people who are treated with tPA. There is also a small risk of infection (less than 1 in a 1,000).