What does the “golden hour” mean in stroke care?

chase the golden hour

Imagine the following trail of events: You start to observe one or more F.A.S.T. stroke symptoms and signs in a person; you call an ambulance; emergency responders arrive at the scene; they determine of a stroke; they rush the person to a stroke unit; the person is treated with a blot clot-dissolving medication.  If all these events occur within the first hour from the time of detection, that is the golden hour.

This is because every passing second matters. Ans this is why we call, “Time is Brain”. Read about it more in the “Journeys to the Brain” series.

Time is the critical factor; 32,000 neurons die every passing second as Jeffrey L. Savers wrote in 2005.

Why this hour is golden? 

A group of Scandinavian researchers (Advani et al. 2017) have shown that irrespective of age and pre-existing disease conditions, those who were treated within this golden hour reached excellent outcomes. This is a very significant finding because age (how old an individual is) should not be considered as a factor to call for an ambulance and to intervene at the hospital. 

Not only that, but other researchers have also demonstrated the importance of this hour.

However, passing this golden hour does not mean that we should lose hope of salvaging the affected brain tissues. The Canadian best practice guidelines advocate the onset-to-needle time as “four and a half hours” (page 3) from the onset of symptoms. 


Advani R, Naess H. & Kurz M.W. (2017). The golden hour of acute ischemic stroke. Scand J Trauma Resusc Emerg Med. 2017 May 22;25(1):54. doi: 10.1186/s13049-017-0398-5.

Author: Ed Jerard

Research analyst and health promoter in Canada

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