Not all hospitals have the most up-to-date technology for evaluating people who may be having a stroke. But emergency rooms with access to a rapid-response stroke center via a consultation system known as “telestroke” can minimize brain damage caused by stroke, according to Stroke: Preventing and Treating “Brain Attack,” a new report from Harvard Medical School.

When stroke symptoms occur, quick action is vital. Getting to a hospital emergency room, preferably one that specializes in treating stroke, is crucial. To prevent brain cell death, treatment is most effective if it starts within an hour of the start of the stroke. One of the main clot-dissolving drugs, tPA, must be given within a few hours after symptoms appear.

Although not all hospitals have experts on staff around the clock who can evaluate stroke patients, most hospitals can start stroke treatment right away if needed. Telestroke protocols and techniques enable doctors at community hospitals to collaborate with expert neurology teams at major stroke centers. After doctors share a patient’s exam results, laboratory tests, and images over a secure Internet connection, videoconferencing enables the stroke experts to guide local physicians through a more complete examination, and then to recommend treatment or rapid transfer to a larger hospital.

Telestroke programs are especially useful for helping physicians at smaller hospitals determine when to use clot-busting therapy, which is appropriate only for certain patients within a narrow time frame. In these hospitals, telestroke may be the only way for a patient to receive this potentially brain-preserving treatment in time. The recent expansion of the therapeutic window for clot-busting therapy, from within three hours after the onset of symptoms to four-and-a-half hours, makes the use of telestroke programs even more important.