Stroke care is evolving, but fast action still matters most

June 2026

At Providence, stroke teams use advanced imaging and rapid evaluation to deliver personalized care designed to preserve brain function and improve outcomes.

Pawani Sachar, M.D., vascular neurologist and medical director of Providence Medford Medical Center's stroke program, explains how new guidance from the American Stroke Association is affecting care and recovery.

What new guidelines mean for patients

Stroke care is changing, and according to Dr. Sachar, it starts with how we think about what’s happening in the brain.

"Think of a stroke as a house fire. Some rooms may already be badly damaged. Some rooms may be filled with smoke and are at risk. Advanced brain imaging helps us see whether there is still brain tissue worth rescuing," she says.

In some cases, Tenecteplase — a clot-dissolving medication — can now be given up to 24 hours after stroke symptoms begin.

For years, clot-dissolving medication was typically given within 4.5 hours of stroke symptoms. New guidance from the American Stroke Association expands that possibility for some patients.

This window offers new hope — especially for people who wake up with symptoms or experience delays in getting care.

Why urgency is still critical

Even with more flexibility in treatment timing, Dr. Sachar emphasizes that immediate action remains essential.

“The message is not we have more time," she says. "The message is still time is brain. Call 911 immediately. Faster is still better."

If symptoms appear at any time, don’t wait or assume it’s too late. Advanced imaging and expert evaluation may still identify treatment options — but only if care is sought quickly.

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