Stroke Stroke

Stroke

A stroke is a major medical emergency and occurs when the brain is damaged due to a change in blood flow. The seriousness of the damage depends on the part of the brain involved and how much of the brain is affected during the stroke. Swiftness of treatment is essential to preserve and restore as much function as possible:

  • St. Luke’s maintains a presence throughout the region with trained stroke specialists who are available 24 hours a day, 7 days a week, with immediate access to each St. Luke’s facility.
  • St. Luke’s works closely with local EMS to shave precious time from the stroke care process.
  • St. Luke’s provides the most effective stroke therapies, including IV tPA (thrombolysis) and intra-arterial thrombectomy available 24 hours a day, 7 days a week.
  • St. Luke’s takes a multidisciplinary team approach to stroke care to address the needs of each individual patient and their family.
  • St. Luke’s uses iSchemaView RAPID™ to generate maps of damaged brain tissue to help determine treatment options. This imaging platform software works with CT perfusion scans to produce clear images of the brain and evaluate blood flow in patients who have had an acute ischemic stroke. By comparing flow in different parts of the brain, doctors can select those patients who will most benefit from thrombectomy, even if it’s up to 24 hours from the onset of stroke.
  • St. Luke’s University Hospital – Bethlehem is accredited as a Comprehensive Stroke Center by the Joint Commission, signifying a high level of expertise and recognizing excellence in care.
Symptoms

There are three types of stroke:

  1. Ischemic – blockage. The more common type — 80 to 85 percent of all strokes.
  2. Hemorrhagic – breakage. Less common but more often fatal.
  3. Transient Ischemic Attack (TIA) -- blood clot. When a blood clot blocks an artery for a short time, it causes a "mini stroke" or transient ischemic attack (TIA).

With stroke, time is brain. The time it takes for you to get to treatment when you have a stroke is critical, so pay attention to your body!

If any of these conditions arise, especially suddenly, get immediate medical help:

  • A loss of balance or coordination, sudden weakness or a severe headache, especially with vomiting or dizziness.
  • Trouble seeing.
  • Sudden paralysis or numbness of face, arms, or legs. If you try to raise your arms above your head, and one arm begins to fall, you may be experiencing a stroke. Similarly, if you smile, and one side of your mouth seems to droop, you may be having a stroke.
  • Trouble speaking or understanding speech.

Every minute that a stroke goes untreated increases the potential of brain damage and disability.

Learn these signs of a stroke, and BE FAST!!

Balance: Is the person experiencing a sudden loss of balance?

Eyes: Does the person have a sudden loss of vision in one or both eyes?

Face: Ask the person to smile. Does his or her face look uneven?

Arm: Ask the person to raise both arms. Does one arm drift down?

Speech: Ask the person to repeat a simple phrase like “the sky is blue.” Does his or her speech sound strange?

Time: If you observe any of these signs, note the time the symptoms started and call 911 or an ambulance.

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Causes

Strokes can have a variety of causes. Among the factors you can control are:

  • High blood pressure
  • Diabetes
  • High cholesterol
  • Sleep apnea
  • Tobacco use
  • Artery disease
  • AFIB (atrial fibrillation, or an irregular heartbeat)
  • Certain blood disorders
  • Obesity
  • Excessive alcohol intake
  • Illegal drug use

Among the risk factors you cannot control are aging, family history, gender, race and whether you’ve had a stroke before. Because you can’t do anything about these kinds of factors, it’s really important to manage the ones you can.

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Living Better

The best way to prevent a stroke is to stay in the best health possible. This may mean taking total control of conditions you have that you’ve been, at best, managing, or, at worst, ignoring. Conditions that put you at higher risk for stroke include:

  • High blood pressure
  • Diabetes
  • High cholesterol
  • Sleep apnea
  • Smoking
  • Arterial disease
  • AFIB
  • Obesity

If you have experienced a stroke, you need to take any medicine as prescribed and follow any lifestyle changes that have been recommended in order to both recover and prevent another stroke. Lifestyle changes can include moderating your eating habits, stopping smoking, and adding exercise.

You may, however, also be experiencing after-effects of your stroke, which can affect various parts of your body. Additional health professionals that may be part of your care team include a speech and language therapist, a swallowing specialist and a physical and occupational therapist.

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Exams and Tests

The emergency team that reaches you will need to decide the type of stroke you’re having and which area of the brain is affected. Local emergency medical teams work in conjunction with St. Luke’s stroke experts and coordinate efforts for your best care.

Your doctor will take your family history in addition to your personal medical history, especially regarding heart disease and stroke. Your blood pressure will be checked, and the health care professional will listen to your carotid arteries.

A CT scan can show the doctor what’s going on in the blood vessels in your brain — any bleeding, the presence of a tumor and other conditions. Magnetic resonance imaging (MRI) can be used as well to show any brain tissue damaged by an ischemic or hemorrhagic stroke. A carotid ultrasound can show images of the blood vessels in your neck, to check for blood flow and buildup.

You may also have an EKG, which measures your heart’s electrical activity and can indicate the presence of AFib or a previous heart attack, or an echocardiograph, which can find the source of clots that may have traveled from your heart to your brain.

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Treatment

Ischemic Stroke

For ischemic stroke, the clot-busting treatment called IV tPA and thrombolytic therapy are the gold standards for care. Other therapies include intra-arterial thrombectomy, which is a procedure that removes a blockage of a blood vessel in the brain.


St. Luke’s has been recognized for our active involvement in Get With The Guidelines® - Stroke and Target Stroke, a program designed to help hospitals make sure patients get the benefits of the latest scientific guidelines-based treatment. Additionally, St. Luke’s is proud to be nationally recognized for stroke care with the top designation by the American Heart Association / American Stroke Association, the Get With The Guidelines Target: Stroke Honor Roll Elite Plus award. The award recognizes St. Luke’s commitment to providing the most appropriate stroke treatments according to nationally recognized research-based guidelines. St. Luke’s works together with local EMS partners to provide fast, evidence-based stroke care so that our patients can achieve the best possible stroke outcomes.

Target: Stroke Honor Roll-Elite Plus: Hospitals achieving time to thrombolytic therapy within 60 minutes in 75 percent or more of applicable acute ischemic stroke patients treated with IV tPA AND door-to-needle time to thrombolytic therapy within 45 minutes in 50 percent of applicable acute ischemic stroke patients treated with IV tPA to improve quality of patient care and outcomes.

Get With The Guidelines

Hemorrhagic Stroke

For this kind of stroke, the priorities are to control the bleeding and reduce the pressure in your brain.

If you have been taking blood thinners for another condition, different medications will be administered to counteract them. You may be given medicines to lower your brain pressure, lower your blood pressure or prevent seizures.

There are a few surgical procedures that may be used to repair blood vessel stresses that either caused or resulted from your stroke. The most common ones include:

  • Aneurysm clipping
  • Coil embolization
  • ArterioVenous Malformation (AVM) repair
  • Stereotactic radiosurgery

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