Time is brain: an expanded concept, not only for ischemic stroke A viewpoint of the Italian Association for Emergency Neurology (ANEU).

BACKGROUND: The concept of time is crucial in managing neurological diseases, as it includes both the natural history of a disease and the urgency of treatment. This paper explores the aphorism "Time is Brain," emphasizing the importance of timely interventions, not only in ischemic stroke, and its applicability to many other neurological conditions. METHODS: The review synthesizes existing literature on the implications of time in various neurological conditions, including ischemic stroke, intracerebral hemorrhage, status epilepticus, and Guillain-Barré syndrome. It evaluates how timely treatment influences patient outcomes, highlighting key time-sensitive interventions and care bundles. DISCUSSION: Timely management, particularly in acute settings, is shown to correlate strongly with improved outcomes. For instance, in ischemic stroke, delays in treatment can lead to significant neuronal loss, quantifiable as "time is brain." Similarly, in intracerebral hemorrhage, early blood pressure management and other interventions within critical timeframes can significantly reduce morbidity. The review also addresses the importance of timing in the treatment of neurodegenerative diseases, where early interventions can change the disease trajectory. CONCLUSIONS: This paper underscores the multifaceted role of time in neurology. It advocates for the incorporation of time-sensitive strategies into clinical practice to enhance patient outcomes across various neurological disorders. Understanding and implementing timely interventions can optimize care and improve prognoses in acute neurological conditions.