Ultimately, many believe these patients will be sent to specialized stroke centers, just as trauma patients are handled.
Places such as Maryland and Hopkins have created stroke units where patients are monitored closely for complications, and staff are better able to control factors such as fever, which can have a big impact on recovery. Studies show that even patients who do not get the clot-busting drug do much better in these units.
Eventually, neurologists hope to expand the time window in which patients can get t-PA. They are also working on other medicines and trying to cool the body as a way to protect the brain after stroke.
Until then, experts say, people should do the same things to avoid other health problems, such as exercising and eating right, and stopping smoking. And because hospitals are handling these cases differently, Marler, of NIH, advises one more step:
"Call your local hospital and see if they have a good system for treating acute stroke," he said. "Part of preventing strokes is to be in the place where they can treat it."