Brain, nerves & mind
Stroke: 4.5 hours and 24 hours
“Nothing can be done, sleep on it” is a leading avoidable cause of stroke disability. Two time windows decide everything.
- 1IV thrombolysis: within 3 h OR 1.75, 3–4.5 h OR 1.26, beyond 4.5 h no significant benefit (6,756-patient meta-analysis)
- 2Benefit holds regardless of age or severity — including over 80
- 3Thrombectomy (large-vessel occlusion): independence 46% vs 26.5%; treat 2.6 to reduce disability in 1
- 4Selected patients can be treated up to 24 h — but only imaging in hospital can tell
- 5Every minute of delay costs about 1.9 million neurons
- 6Don’t drive yourself, don’t take pills first, don’t wait for family
Kidney patients especially: emergency imaging tells ischaemic from bleed; thrombolysis and thrombectomy are not contraindicated in CKD.
Caption (ready to paste)
“Nothing can be done, sleep on it” is a leading avoidable cause of stroke disability. Two time windows decide everything. 1. IV thrombolysis: within 3 h OR 1.75, 3–4.5 h OR 1.26, beyond 4.5 h no significant benefit (6,756-patient meta-analysis) 2. Benefit holds regardless of age or severity — including over 80 3. Thrombectomy (large-vessel occlusion): independence 46% vs 26.5%; treat 2.6 to reduce disability in 1 4. Selected patients can be treated up to 24 h — but only imaging in hospital can tell 5. Every minute of delay costs about 1.9 million neurons 6. Don’t drive yourself, don’t take pills first, don’t wait for family Kidney patients especially: emergency imaging tells ischaemic from bleed; thrombolysis and thrombectomy are not contraindicated in CKD. Sources: Emberson J et al. Alteplase IPD meta-analysis — Lancet 2014; Goyal M et al. HERMES thrombectomy IPD meta-analysis — Lancet 2016 Verified: 2026-10-17 Cards and scripts are general health education compiled from public clinical guidelines. They are not individual medical advice and do not replace assessment by your doctor, pharmacist or dietitian. Please keep the sources and this notice when sharing; this page holds the latest version. https://beyondckd.com/en/cards/stroke-time-is-brain
60-second short-video script
Shot list and voice-over. Vertical 9:16; put captions in the lower third. Every line maps to the sources on the left.
| sec | Screen | Voice-over |
|---|---|---|
| 0–5 | Stopwatch | A stroke — watch overnight and see? |
| 5–25 | 4.5-hour hourglass | Nine trials, 6,756 people: clot-buster within 3 hours raises the odds of no disability by 75%; after 4.5 hours the benefit is gone. |
| 25–45 | 46% vs 26.5% | Thrombectomy for large-vessel occlusion: independence rises from 26.5% to 46% — fewer than 3 treated to help 1. |
| 45–60 | Emergency number | Every minute costs 1.9 million neurons. Note the time, call emergency services. Kidney patients too — these treatments are not off-limits. |
Sources (every point on the card maps to one)
- Emberson J et al. Alteplase IPD meta-analysis — Lancet 2014
- Goyal M et al. HERMES thrombectomy IPD meta-analysis — Lancet 2016
Verified: 2026-10-17