AANS Neurosurgeon | Volume 27, Number 3, 2018

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Rethinking the Stroke Rule "Time is Brain"

In 1993, neurologist Camilo R. Gomez, MD, coined a phrase that for a quarter century has been a fundamental rule of stroke care: “Time is brain!”

“Unquestionably the longer therapy is delayed, the lesser the chance that it will be successful,” Dr. Gomez wrote in an editorial 25 years ago. “Simply stated: time is brain!

But the “time is brain” rule is not as simple as it once seemed, Dr. Gomez now argues in his most recent paper. Dr. Gomez is a Loyola Medicine stroke specialist and nationally known expert in minimally invasive neuroendovascular surgery.

It is still true that stroke outcomes generally are worse the longer treatment is delayed so it remains critically important to call 911 immediately after the first signs of stroke. But, Dr. Gomez reports, the effect of time can vary greatly among patients. Depending on the blood circulation pattern in the brain, emergency treatment could greatly help one patient, but be too late for another patient treated at the same time.

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