How long was she "in an obtunded state" before anyone took her seriously? The line about it being too late for acute interventions makes me think it was quite a long time in stroke terms. I think they're taking about recombinant tissue plasminogen activator (tPA), which is a thrombolytic medication that is given as a single intravenous injection. It "dissolves" the clot blocking the blood vessel in the brain, restoring blood flow to the damaged tissue and reversing some of the effects of the stroke. Since it came to market in the 1990s, tPA has revolutionized acute treatment of stroke and vastly improved patient survival.
It needs to be given as soon as possible, because the longer the tissue is without adequate blood, the larger the damaged area and the more likely it is that the oxygen-starved cells will die. Unlike the other organs, dead brain tissue can't really repair itself by producing new healthy cells, although it tries. If too much of the brain tissue is completely dead, there's no point in administering tPA. The prescribing information indicates that it should be given within 3 hours of the onset of stroke symptoms, but in research settings, benefit has been shown at up to 4.5 hours. In practice, a lot of doctors are willing to fudge it a little and give tPA even if it's been slightly longer, because the benefits in many cases outweigh the risks. Especially in younger patients, the possibility that tPA will reduce at least some of the post-stroke functional deficits mean it's worth a shot, literally and figuratively, even if it's technically been too long. This patient was 23. In my experience, physicians are really willing to pull out all the stops attempting interventions in anyone that young, because they theoretically have so many years left to live and can withstand intensive treatment.
The fact that they concluded intervention would be pointless in an otherwise healthy 23 year old suggests to me she was down for hours, possibly even a day or so. Since she wouldn't have been capable of voluntary movement, she couldn't have called for help herself, so it's not really her fault, but I think that it speaks to how socially isolated she must be. Nobody even thought to check on her? There were no friends or family members who thought it was unusual that she abruptly stopped responding to their texts or calls? She wasn't expected at a job or school? I really want to know the back story on this one.