New Ways to Save Your Brain During Stroke large

If you or a loved one has a stroke, you need immediate medical attention to restore blood flow and oxygen to your brain. The sooner you receive treatment, the less your risk of permanent brain injury, disability or death.

The good news: The chance you’ll receive timely treatment of stroke is greater today than ever before. New technology and advances in stroke treatment systems make this possible.

Faster Care, No Matter Where You Live

New Ways to Save Your Brain During Stroke smallTechnology is opening the way to more immediate stroke treatment, even if you live in a remote area, away from major medical facilities that are staffed by physicians trained in stroke treatment.

TeleStroke networks, such as Premier Health’s, provide 24/7 access to teams of stroke specialists via the internet. TeleStroke virtually links the specialists with emergency medical personnel as they treat patients in hospitals without stroke-trained physicians.

Using video equipment, an internet connection and other technology, the off-site specialists can quickly evaluate the patient. And they partner with the emergency medical team to treat the patient to minimize the stroke’s effects.

The National Institutes of Health reports that some studies have found that TeleStroke networks help control medical costs and result in more stroke patients being discharged to home from the hospital.

Bryan Ludwig, MD, of the Premier Health Clinical Neuroscience Institute, explains the benefits of TeleStroke networks. “Treatment of stroke is time-dependent,” he says. “The faster you do it, the better the outcome for the patient.”

“Treatment of stroke is time-dependent,” he says. “The faster you do it, the better the outcome for the patient.”

Dr. Ludwig talks about TeleStroke. Click play to watch the video or read the transcript.

 

Check a Hospital’s Stroke Credentials

Many hospitals that provide stroke care meet standards that support better patient outcomes. John Terry, MD, of the Premier Health Clinical Neuroscience Institute, explains the two levels of stroke centers established in hospitals around the U.S.

Advanced primary stroke centers, certified by The Joint Commission. Click play to watch the video or read the transcript.

 

Comprehensive stroke centers, certified by The Joint Commission. Click play to watch the video or read the transcript.

 

Advanced primary stroke centers focus on rapid evaluation and treatment of stroke patients. They use the clot-dissolving medication tissue plasminogen activator (tPA) to treat the most common type of stroke, ischemic, in which clots block blood vessels. Nationwide, only two percent of patients appropriate for tPA receive the treatment, Dr. Terry says. But this statistic increases to 15 to 20 percent where primary stroke centers are available, he explains.

Comprehensive stroke centers also administer tPA, but add to their treatment capability a clot-retrieval technique, explained below, and techniques to treat less common hemorrhagic strokes that involve blood vessels that rupture in the brain. These techniques include advanced imaging, surgery, careful blood pressure control and monitoring, and intensive care in the hospital.

Both advanced primary and comprehensive stroke centers must meet specific standards of care and performance measures focused on improved patient outcomes. This includes maintaining a staff of medical professionals specially trained in stroke care.

Comprehensive stroke centers require additional technology and resources to maintain their certification. This includes demonstrated availability of advanced imaging technology and 24-hour availability of staff trained in vascular neurology, neurosurgery and endovascular procedures.

Comprehensive stroke centers may be at least partially responsible for improving hemorrhagic stroke survival, according to a recent study published in the Journal of the American Heart Association.

A New Procedure: Endovascular Stroke Rescue

In some cases, stroke patients don’t immediately respond to medication therapy. And some patients, due to certain medical conditions, may not be good candidates for tPA drug therapy. In these instances, a new minimally invasive procedure – endovascular stroke rescue – has become the recognized standard of care, says Dr. Ludwig.

Dr. Ludwig explains the procedure. Click play to watch the video or read the transcript.

 

A doctor threads a catheter through an artery in the groin, up to the blocked artery in the brain. The catheter moves a stent, a wire-caged device, to the blockage. The stent opens, grabs the clot, and the doctor removes the stent with the trapped clot. 

This procedure can up done up to 24 hours after stroke symptoms begin. 

In 2018, the timeframe for this procedure expanded from six to 24 hours after stroke symptoms begin. Dr. Ludwig discusses the expanded guidelines:

Dr. Ludwig adds that the most recent trial showed that for patients with stroke symptoms starting more than six hours before they arrive to the hospital (but no more than 24 hours from the onset of the stroke) and who qualified for surgical removal of clots, nearly 50 percent were doing well at three months. This was compared to similar patients who didn't receive the surgery, where only 13 percent of patients were doing well three months after their stroke. And timely treatment is more likely now due to stroke care innovations such as TeleStroke and advanced and comprehensive stroke care centers.