“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.
Preventing Stroke
“I have always been athletic, and was in great shape, but didn’t
have a clue how high my blood pressure was…”
While there is a chance that anyone could have a stroke, our goal is help
to reduce your risk to that of the general population. Many factors can
increase your risk of having a stroke; some which you cannot control …
Increasing age
Male gender
Family History / Genetics
Race
Certain diseases (atrial fibrillation, cancer, autoimmune conditions)
… but many more factors that you can directly control, not only
to reduce your risk of stroke, but improve your overall health!
Tobacco Abuse (Cigar, Cigarettes, Vaping, and Dip)
High Blood Pressure
High Cholesterol
Diabetes
Obesity
Sleep Apnea
Excessive Alcohol Abuse
Drug Abuse (including Cocaine, Heroin / Opiates, PCP)
Medication Non-compliance
The best way to treat a stroke is never to have a stroke, so if you have
one or many of these disorders, contact our team who can begin a personalized
treatment plan reducing your risk of ever facing this disease.
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.
