Abstract:
Background. The critical time in stroke is the optimal period for administering
thrombolysis, which restores blood flow to the brain and prevents permanent damage. The
expression “time is brain” emphasizes the critical importance of early medical involvement,
since every minute significantly impacts patient outcomes.
Objective(s). Analysis of the importance of early diagnosis of stroke in the prehospital
phase and the impact of the critical time on the development, treatment, and prognosis of
patients.
Materials and methods. The study analyzed national and international literature, including
scientific articles and clinical guidelines, focusing on tools to extend the optimal therapeutic
timeframe in acute stroke. Data were supplemented with information on algorithms and
checklists used by the prehospital emergency service in Moldova, forming the basis of the
analysis.
Results. At the prehospital stage, rapid identification of stroke is vital for prompt initiation
of treatment and reduction of complications. For this purpose, standardized scales such as
FAST, CPSS, RACE, and NIHSS are used, which allow fast identification of the
symptomatology. The treatment used in the first 3 hours significantly increases the chances
of a favorable outcome. Due to the risk of aggravation, hospitalization in intensive care or
specialized centers is essential. Reducing treatment time by 30 minutes raises the chance of
a Rankin score 0-1 at 90 days by 1.8%, and cutting "door-to-needle" time by 10 minutes adds
0.2% to good outcome.
Conclusion(s). Timely therapeutic intervention is important for the effective treatment of
acute ischemic stroke. Early administration of intravenous thrombolysis and mechanical
thrombectomy has proven effective in minimizing cerebral damage, enhancing functional
recovery, and reducing mortality.
