Stroke Care - Deck: Seeking Trophy Catches
By Jennifer Smith / March 2012

Stroke can present as sudden blindness, difficulty speaking, a sudden severe headache, numbness or weakness on one side of the body, and dizziness. Or, less obviously, it can appear as confusion, slurred speech and an imbalanced gait. All of these symptoms are indicators that a person may be having a stroke.

Stroke is caused by a blocked blood vessel or bleeding in the brain. Oxygen is unable to get to the brain, and, after about four minutes, brain cells become damaged and ultimately start dying. Damaged brain cells are then unable to control the parts of the body that are regulated by the area of the brain affected by the stroke.

Until recently, stroke has been the third leading cause of death in the U.S. But, according to the American Heart Association, federal statistics show stroke has declined to the fourth leading cause of death. The decline can be attributed to successful educational outreach; medical advances in stroke treatment and other factors. However, the statistic is slightly misleading.
"Mortality is down, but the population is aging as a whole because of baby boomers, so the prevalence of stroke is increasing," says neurointerventional neurologist Ridwan Lin, M.D., PhD., of the Comprehensive Stroke Center at Broward Health North Broward Medical Center (NBMC).

While the risk of stroke can be mitigated by living a healthy lifestyle that eliminates smoking, lowering cholesterol and blood pressure, and limiting other risky behaviors, stroke will inevitably impact some families. If stroke is suspected, it is imperative to seek medical attention as quickly as possible. That raises the question of whether an individual should be transported to the nearest hospital or to a hospital with a comprehensive stroke center.

While Lin admits this question is a touchy subject, he stresses that time is of the essence. There is only a four-and-a-half-hour window when the drug t-PA, which is used to treat ischemic stroke, can be administered. "Go to the closest hospital to get the drug," he says.

If the four-and-a-half-hour window has elapsed or a patient is of equal distance from hospitals with and without a comprehensive stroke center, Lin always encourages the patient to be transported to the hospital with the comprehensive stroke center. Only at a comprehensive stroke center, such as available at NBMC, will patients have access to FDA-approved devices like the Merci Retriever® and Penumbra System®, which may be the patient's only hope for regaining some functionality or, more critically, survival.

The Merci Retriever® is a corkscrew-shaped device designed to remove blood clots from large vessels. The Penumbra System® is a tool that uses vacuum suction to grab blood clots in the brain for treatment of stroke.

After a stroke, it is almost inevitable that some form of rehabilitation will be necessary, whether to regain mobility or improve speech. "Obviously we give the best care to minimize stroke, but usually some rehabilitation is needed," says Lin. "It is imperative to bringing patients back into society."

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