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Stroke: The Need For Speed

When stroke symptoms appear, quick action can make all the difference.

Each year, nearly 800,000 people in the U.S. experience a new or recurrent stroke – a sudden disruption in blood supply to the brain. Stroke is the fifth leading cause of death and the leading cause of adult disability in the nation.

The statistics are scary, but there’s another, more hopeful number to keep in mind: Up to 80 percent of strokes can be prevented. Additionally, advanced treatments—particularly if administered soon after the stroke—are helping doctors minimize the effects of stroke and save lives.

REDUCING RISK

“The main and best approach to stroke is to prevent it altogether,” explains neurologist Danielle Haskins, MD, Medical Director of the Comprehensive Stroke Center at Saint Barnabas Medical Center (SBMC). “I very much encourage people to keep in touch with their primary care physician and keep on top of their medical risk factors.”

Some risk factors for stroke can be controlled with lifestyle changes and medication:

  • High blood pressure
  • Smoking
  • Diabetes
  • Physical inactivity
  • High cholesterol
  • Poor diet
  • Obesity

While other contributing factors can’t be controlled, people should be aware of them:

  • Age (65 years or older)
  • Gender (women have more strokes than men)
  • Race (African-Americans, Hispanics and Asian/Pacific Islanders have a higher risk)
  • Family History (a parent, grandparent or sibling has had a stroke, especially before age 65)

WHEN TO CALL 911

When a stroke occurs, every minute matters. “’Sudden’ is the key word when it comes to stroke symptoms,” explains Dr. Haskins. “A stroke starts abruptly because the blood supply to the brain is interrupted abruptly. It’s not typically something where the weakness gets gradually worse over the course of days; usually, with a stroke, one minute you’re fi ne and the next minute you’re not.”

Just as symptoms come on fast, rapid treatment is essential for a stroke—but many people don’t act right away. “People are very good at convincing themselves that symptoms couldn’t be anything serious,” says Dr. Haskins. “Doctors will hear things like, ‘I thought I couldn’t move my arm because I was too tired,’ or ‘I felt sick, so I just went to sleep.’”

Calling 911 immediately is the best thing to do in most cases, according to the Centers for Disease Control and Prevention. An Emergency Medical Services (EMS) team will take you to the nearest hospital that specializes in stroke treatment, such as a comprehensive stroke center like the one at SBMC.

EMS professionals can begin treatment while on the way to the hospital. Crucially, the EMS team can call ahead to give the hospital time to prepare for your arrival. At SBMC, “BAT”—for Brain Attack Team—experts have established fast communications with area EMS units so that they can be ready the moment a stroke victim comes through the door.

Once at the hospital, the type of treatment a stroke patient receives depends on the type of stroke he or she has suffered (see sidebar at right). The drug Alteplase IV, considered the gold standard for treating blockages, will likely be deployed in many cases.

“Alteplase must be given within four and a half hours aft er the person was last known to be in his or her normal health,” says Dr. Haskins. “However, if we can give it to the patient even earlier than that, he or she will likely do far better.”

TYPES OF STROKE

ISCHEMIC STROKE: In this, the most common kind of stroke, a blood vessel gets blocked by a blood clot or piece of cholesterol plaque. The brain is deprived of the blood and oxygen it needs, leading to damage and death of brain cells. Ischemic strokes are treated by breaking up clots, either with a catheter or with the drug Alteplase IV.

HEMORRHAGIC STROKE: A blood vessel ruptures and causes bleeding into or around the brain. The bleeding leads to swelling and pressure, damaging brain cells and tissue. Hemorrhagic strokes are treated with a combination of medical and sometimes surgical care. In the case of aneurysms or blood vessel malformations, they can be treated by guiding a catheter to the source of the bleeding and depositing a mechanical agent to prevent further rupture.

The Comprehensive Stroke Center at Saint Barnabas Medical Center is state-designated to treat all phases of stroke and is a Joint Commission-certified advanced primary stroke center. To learn more, call 973.322.6500 or visit our website.