The 3-hour window of time for a fatal cerebral infarction

Stroke is divided into ischemic stroke and hemorrhagic stroke. Although the pathogenesis is different, both of them are aggressive and their conditions can change drastically within a short period of time, so rescue must be a race against time. For example, in the case of ischemic stroke, the most common cause is the formation of blood clots in the arteries of the brain, or blockage by emboli from other parts of the body, resulting in ischemia in the corresponding part of the brain. Our brain relies on its blood supply arteries to carry fresh blood from the heart and lungs, which bring oxygen and nutrients to the brain, while carrying away carbon dioxide and cellular metabolic waste. Once the arteries become blocked, the brain cells cannot produce enough energy and the brain cells in the core area usually stop working within a few minutes. There is an area around it, which we call the “ischemic semidark zone”, where brain cells are temporarily in transition after the ischemia occurs. The focus of our rescue is to restore this part of the brain cells, so that they will transform for the better and not become degenerative and necrotic. The most effective way to promote the transformation of this part of the brain cells is early thrombolysis. In other words, drugs are used to dissolve the thrombus and “remove the roadblock” so that the artery can be reopened and blood flow can pass smoothly. However, the timing of thrombolysis is limited and the effective time is very short. It has a strict “time window”, that is, thrombolysis is effective for most patients within the first 3 hours of acute cerebral infarction, and it may be effective for some patients from 3 to 6 hours, so that the blocked blood vessel can be reopened and the function of brain tissue will not be seriously damaged, and there are few sequelae. If thrombolysis is performed more than 6 hours later, it is of little significance, as irreversible necrosis of brain cells has already occurred at that time. Therefore, for stroke, the early or late treatment is the key to determine the prognosis. Time is brain and time is life. Seize the 3 hours, can effectively save a life, can not seize, can be fatal. However, the current situation in China is that 99% of patients cannot get effective thrombolytic treatment within 3 hours, so that the prognosis is very poor and most patients are left with serious sequelae. The treatment of cerebral infarction with neurology alone is not sufficient or comprehensive, but requires neurosurgical intervention and joint consultation to achieve the best outcome for the benefit of patients.