Tpa As Stroke Treatment: Pros And Cons

Strokes are a leading cause of death worldwide, with approximately 800,000 people suffering from one every year. While strokes used to be quite deadly, they have become less so over the years, with improved management of cardiovascular risk factors, greater awareness of symptoms, and novel treatments. One such treatment, the tissue plasminogen activator (tPA), works to dissolve clots that block blood flow to the brain. This treatment has become controversial because it can be helpful to some patients and quite harmful to others. Learn more about the benefits and risks of tPA as a stroke treatment and what you can do if you have been harmed from the improper implementation of this treatment.

What Happens During a Stroke?

There are two types of strokes: ischemic and hemorrhagic. Ischemic strokes are caused by the blockage of an artery in the brain; approximately 87% of strokes are ischemic. Hemorrhagic strokes are caused by bleeding in the brain; approximately 13% of strokes are hemorrhagic. The treatment a patient receives depends on the type of stroke they have.

For ischemic strokes, physicians may recommend the following treatments to quickly restore blood flow to the brain:

  • Emergency IV medication, including tPA. tPA is usually given to stroke patients within the first three hours of a stroke. tPA may dissolve the clot causing the ischemic stroke and help patients more fully recover.
  • Emergency endovascular procedures. Physicians may decide to remove the clot directly, such as by inserting a catheter through a vein, threading it into the brain, and delivering tPA directly. Another option is to remove the clot with a stent, which could be beneficial for larger clots that tPA cannot dissolve on its own.

For hemorrhagic strokes, physicians may recommend the following treatments to control the bleeding in the brain:

  • Emergency medications. Physicians may give patients drugs to lower the blood pressure in the brain (intracranial pressure), prevent spasms of the blood vessels, and prevent seizures.
  • Surgery. Surgery may be used to remove large amounts of blood in the brain or repair blood vessels associated with the stroke.
  • Stereotactic radiosurgery. This less-invasive procedure uses beams of focused radiation to repair blood vessel malformations.

Recognizing Stroke Symptoms

The sooner you receive treatment for a stroke, the fewer and less severe the long-term effects may be. Symptoms may include the following:

  • Trouble understanding words or speaking
  • Numbness or weakness of the face, arm, or leg
  • Blurry or blackened vision in one or both eyes
  • Drooping face or eyelid
  • Double vision
  • Sudden, severe headache
  • Confusion
  • Vomiting
  • Dizziness
  • Difficulty walking
  • Impaired balance or coordination 

Understanding tPA as a Stroke Treatment

tPA is often used to treat ischemic strokes. It must be administered to the patient within three hours of the stroke’s onset, as approved by the U.S. Food and Drug Administration (FDA).

tPA is an enzyme that cleaves peptide bonds in proteins and is found on endothelial cells that line the body’s blood vessels. It catalyzes the conversion of plasminogen to plasmin, another enzyme responsible for clot breakdown or dissolution, thereby helping restore blood flow to the brain. Examples of tPA drugs include alteplase, reteplase, and tenecteplase. There are several benefits and risks of tPA as a stroke treatment, including the following:

Benefits of tPA

tPA can be quite beneficial in dissolving blood clots and improving a patient’s odds of recovering from a stroke. At the very least, tPA may make the long-term effects of a stroke less devastating. However, the benefits of tPA depend largely on when it is administered.

Risks of tPA

In certain situations, tPA can cause more harm than good when treating a stroke. This is particularly true if tPA is administered outside the recommended time frame. When administered incorrectly, tPA can cause additional bleeding in the brain without doing much to treat the stroke. According to the Thunder Bay Regional Health Sciences Centre, the chance of bleeding into the brain in patients who receive tPA is about 3% as opposed to only 0.2% for those who do not.

If bleeding into the brain occurs after tPA is given, the stroke symptoms may become worse and may even result in death for the patient.

Before tPA Treatment

Before tPA administration, you will undergo a computed brain tomography (CT) scan. This is because it is hazardous for some patients to receive due to having one of the following health conditions: 

  • Hemorrhagic stroke 
  • Brain aneurysm or AVM
  • Head injuries
  • Bleeding or blood clotting disorders
  • Bleeding ulcers
  • Trauma
  • Pregnancy
  • Uncontrolled high blood pressure

If any of the above apply to you, tPA will not help you and could, in fact, cause you significant harm.

Who Qualifies for a tPA Stroke Injury Claim?

Health providers can be held liable for a patient’s stroke injury if it was the result of failing to administer tPA properly, such as in the following cases:

  • Administering tPA outside of the appropriate time window
  • Using tPA as a treatment for an incorrect type of stroke
  • Giving the patient tPA without performing tests to ensure this treatment is the best course of action
  • Failing to inform the patient that tPA is a possible option
  • Failing to advise the patient of the risks of administering tPA

Proving a Health Provider’s Liability in a tPA Stroke Injury Case

If you are the victim of medical malpractice involving the incorrect use (or non-use) of tPA, you may be entitled to file a civil lawsuit against certain health providers or facilities for damages. However, providing a medical professional’s negligence or wrongdoing can be challenging, and you will have to demonstrate the following four elements for a medical malpractice case:

  • The health provider owed you a duty of care or a responsibility to keep you safe from harm.
  • The health provider violated their duty of care and failed in their responsibility to you.
  • You suffered injuries as a result of their violation.
  • Your injuries resulted in compensatory damages and physical, emotional, or financial losses.

A medical malpractice attorney can help you establish that your health provider was negligent and prove they are liable for your damages.

Damages for Which a Health Provider May Be Liable for a Stroke Injury

If a health provider was responsible for harming you, a medical malpractice lawsuit filed within the state’s statute of limitations could result in compensation for your injuries and losses. Depending on the factors in your case, you may be entitled to receive the following damages:

  • Medical expenses, such as emergency care, hospitalization, surgery, physical therapy, etc.
  • Costs of accessibility devices, such as a wheelchair
  • Costs of assisted living or in-home care
  • Loss of past and future income, diminished earning capacity
  • Pain and suffering and emotional distress
  • Other damages

Wrongful Death Damages in tPA Stroke Treatment Case

If you have lost a family member due to a health provider’s negligence, you can file a wrongful death claim for damages, such as loss of income, loss of companionship, grief, and funeral and burial expenses. Maryland’s statute of limitations for a claim is three years from the date of the incident that resulted in a loved one’s death.

Suffered from Medical Malpractice After a Stroke? Contact Us Today

A stroke is a severe, potentially lethal medical condition that requires immediate treatment. If you experienced a stroke and your healthcare provider failed to administer the proper treatment, our medical malpractice lawyer can determine if you have a viable claim. You may be eligible to receive compensation for medical expenses, lost income, pain and suffering, and more. Call us today for a free consultation to learn more about your legal options.

X-ray of skull
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