Stroke
Surviving Stroke
“I woke up and couldn’t move the right side of my body… I tried to call out but couldn’t speak…”
Almost 800,000 people in the US have a stroke each year. This means about every 40 seconds, someone has a stroke, and every 4 minutes someone dies of stroke.
However, in the past decade major advances in medicine and surgery have substantially decreased the rates of death and permanent disability, bringing hope to those suffering from this disease.
Recognizing Stroke
“His face looked different, there were no lines on the right, and I didn’t know what was happening…”
The most critical piece to surviving stroke is the quick recognition of stroke and activation of emergency medical services. Usually, stroke causes a sudden onset loss of function in movement, sensation, speech, or vision. In some cases, bleeding strokes can cause a sudden onset, severe headache. Remember to BE FAST –
Balance
Sudden loss of balance or coordination
Eyes
Sudden, persistent blurred or double vision, or other vision trouble.
Face
Sudden numbness or weakness in the face or an uneven smile.
Arm
Sudden numbness or weakness in arm or leg, usually on one side of the body.
Speech
Sudden difficulty speaking or understanding.
Time = Brain
If these symptoms occur suddenly, or are accompanied by sudden, severe dizziness or the worst headache of your life, call 9-1-1.
Defeating Stroke
“In the ED, they evaluated the patient immediately and told me they can give a clot busting medication to help…”
As noted above, the quicker that one recognizes the symptoms of stroke and contacts 9-1-1, the sooner we can evaluate and treat a stroke.
When a patient arrives in the emergency department, we will ensure that they are stable. After breathing and heart function are confirmed, we will obtain computed tomography studies (CAT Scans) to look for any bleeding in the brain, or blockage of the brain’s blood vessels.
Ischemic Stroke – Blood Vessel Blockage
- When a blood vessel is blocked, oxygen and nutrients aren’t delivered to the brain
- Without oxygen and nutrients, the brain becomes stunned and ceases to function
- If blood flow fails to be restored, the brain tissue will be irrevocably killed
If a patient with Ischemic Stroke arrives and is diagnosed within 4 ½ hours, the American Stroke Association recommends giving a medication known as alteplase, or more commonly “tPA”. This medication can circulate and breakup blood clots, restoring blood flow.
In some cases, if a larger blood vessel is blocked in the brain or carotid artery, the patient can undergo an immediate surgical procedure known as “Neurointervention”. This procedure involves the use of tiny catheters to remove the blockage from inside the blood vessels, as well as placing stents or using balloons to open up closed off vessels.
Hemorrhagic Stroke – Blood Vessel Rupture
- Damage to blood vessels, or malformations in blood vessels can result in the vessel cracking
- Bleeding into the brain can cause swelling and damage to the brain, and damage to other blood vessels
- If not treated quickly, continued bleeding can cause pressure to build up inside the skull which can be fatal
Once a patient with hemorrhagic stroke has been diagnosed, they must be started on medications to aggressively control blood pressure. If any blood thinner medications like Eliquis (apixaban), Xarelto (rivaroxaban), or Coumadin (warfarin) are used, antidote medications can be given to stop the bleeding.
In some cases, if bleeding is significant enough, surgical procedures such as placement of a drain, or decompression of the bleeding may be necessary to prevent further injury from occurring.
Patient Outcomes
If your provider has told you that you need expert stroke treatment, we want you to know that West Jefferson Medical Center is ready to care for you! Below, you will also find information about how well our patients do after common procedures at our facility.
Definitions:
Thrombectomy – a minimally invasive surgery that uses catheters to remove a blood clot and improve blood flow.
Diagnostic Cerebral Angiogram – a minimally invasive surgery that uses catheters to inject die into the vessels in the brain to see any possible aneurysms, blockages, or narrow areas that may limit blood flow
Carotid Endarterectomy (CEA) – a surgical procedure to remove build up of fatty pieces (plaque) which causes narrowing of the vessel and can limit blood flow to the brain
Carotid Artery Stent (CAS) – a minimally invasive surgery that involves placing a small mental coil (stent) into a clogged artery to help keep the artery open and lower the changes of the artery narrowing again.
Transcarotid Artery Revascularization (TCAR) – a minimally invasive surgery that uses surgical balloons and small metal coils (stents) to reopen a clogged or narrowed artery
Median number of minutes from time of arrival at WJMC to start of treatment with clot busting medication:
2024 (Jan-June): 35 minutes
Percentage of patients WITH significant bleeding in the brain following treatment with clot busting medication:
2024 (Jan-June): 0%
Median number of minutes from time of arrival at WJMC to start of treatment with thrombectomy:
2024 (Jan-June): 58 minutes
Median number of minutes from the time of arrival at WJMC to the time excellent restoration of blood flow is achieved:
2024 (Jan-June): 88.5 minutes
Percentage of patients WITH significant bleeding in the brain following a thrombectomy procedure:
2024 (Jan-June): <5%
Percentage of all stroke patients discharged to home or rehab:
2024 (Jan-June): 75%
Percentage of patients who experienced stroke or death in the 24 hours following their Diagnostic Cerebral Angiogram:
2023-2024 (Jan-June): <1%
Percentage of patients who did NOT have symptoms prior to their procedure and experienced stroke or death in the 30 days following their CEA/CAS/TCAR:
2023-2024 (Jan-June): <2%
Percentage of patients who had symptoms prior to their procedure and experienced stroke in the 30 days following their CEA/CAS/TCAR:
2023-2024 (Jan-June): <4%
Percentage of patients who had symptoms prior to their procedure and experienced death in the 30 days following their CEA/CAS/TCAR:
2023-2024 (Jan-June): <2%
Caring for Stroke
“I was afraid I’d ever be able to walk again; to care for my family, to not be a burden…”
Our involvement in your care does not end in the hospital. Most patients who suffer from either type of stroke may benefit from rehabilitation. In order to best facilitate your recovery, your rehab team will customize a therapy plan to your individual recovery needs. This plan will focus on helping you regain function lost from your stroke; thus, restoring your independence, and highest quality of life.
Rehab helps you regain strength, relearn skills, or find new ways of doing the things you did before your stroke. Each individual stroke is different, so each person’s recovery will be different. Your rehab team will include you and your family along with speech, physical, and occupational therapists, physicians, nurses, social workers, and case managers. This multidisciplinary team will work with you every step of the way, facilitating a safe recovery process.
On-Site Rehabilitation Care
West Jefferson Rehab Care is a 24-bed inpatient, comprehensive, rehabilitation facility located on the 4th floor of West Jefferson Medical Center. In addition to providing experts in all disciplines of rehabilitation, patients have access to stroke experts, imaging resources, and therapies.
Additionally, our outpatient rehab program at Rehab Connection provides outpatient rehabilitation services for those patients who do not require inpatient therapy but will benefit from additional therapy after their inpatient care has concluded.
Your Care Team
Ina Dragicevic, BSN, RN, SCRN
Stroke Patient Navigator
Alyana Samai, MPH
Director of Neuroscience