Just as time is muscle when it comes to heart attacks, time is brain when treating stroke. How do John C. Lincoln's neurologists care for stroke patients? Treatment depends on the type of stroke, the length of time elapsed since the stroke's onset and the stroke's location.
If you or a loved one encounters stroke symptoms, please call 9-1-1 immediately. Every minute counts. The sooner a patient can receive stroke treatment, the more able we are to minimize brain cell damage.
Door to CT Time
"Door to CT time" is one of our standards for delivering excellent medical care to stroke patients. It is a measurement of the time that passes between each stroke patient's arrival in the emergency room and the moment we interpret a diagnostic CT scan — the key instrument for determining the type of stroke.
At John C. Lincoln, our stated goal for door to CT time is 45 minutes. Faster diagnosis enables us to provide the necessary treatment, such as blood clot-bursting tPA for ischemic strokes, and help limit damage to the brain.
Once they arrive at our emergency rooms for stroke treatment, patients are immediately examined to determine the type, location and severity of their strokes.
Our diagnostic tools include:
- 16-slice CT scanner technology: A high-powered X-ray machine that produces "cross-section" images.
- MRI: Magnetic resonance imaging, which determines cellular changes in the brain.
- Electrocardiography: A tool that checks for irregular heart beat — such as atrial fibrillation, a risk factor for stroke — and can tell if the heart is experiencing ischemia (lack of oxygen in the blood). Quite often, a heart attack and stroke can happen at the same time.
Ischemic Stroke Treatment
When we detect ischemic stroke, our neurology team may employ a clot-dissolving drug called tissue plaminogen activator, or "tPA," which we administer intravenously, through the arm. Underscoring the need for rapid care, tPA can be given only within three hours of a stroke's onset, when it is most effective.
When blood vessels are narrowed, a procedure called cerebral angioplasty may be necessary. Resembling an angioplasty for the heart, this stroke treatment relies on guiding a catheter from the carotid artery (in the neck) to the narrowed artery, then inflating a small balloon to restore proper blood flow.
Hemorrhagic Stroke Treatment
In a hemorrhagic stroke, treatment is based on the underlying cause of the hemorrhage and the extent of damage to the brain. Quite often, hemorrhagic stroke patients are treated in our intensive care unit, where we can carefully ward against irregular breathing and administer appropriate medications.
When bleeding from hemorrhagic stroke spreads through the brain, pressure within the skull (intracranial pressure, or "ICP") can increase — and this is extremely dangerous. To monitor and relieve the pressure, a surgical procedure called a ventriculostomy may be necessary. With this stroke treatment, we insert a tube through a hole in the skull, which can be used to drain cerebrospinal fluid, allowing more room for the brain to swell, if necessary. A ventriculostomy also can be used to measure the pressure in the brain, which indirectly indicates the amount of swelling. In turn, we're able to make better decisions in medications and therapies that we might administer, to save brain.
Stroke Rehabilitation and Recovery
Stroke rehabilitation is a process — one that may take days or months — that begins by stabilizing the patient in the hospital. First and foremost, our neurology team strives to prevent the recurrence of stroke, namely by carefully controlling risk factors, such as high blood pressure and diabetes.
Our physicians, nurses and therapists collaborate to help our patients overcome new challenges, relearn lost skills and regain motor controls. While damaged brain cells cannot grow back, stroke survivors can learn to adapt and gradually resume activities of daily living — such as walking, speaking, cooking and dressing. Throughout stroke rehabilitation, we strive to instill in our patients a positive, goal-oriented attitude.
Stroke Support Group
John C. Lincoln offers a Stroke Support Group designed to share coping skills and information about stroke with stroke survivors and their families.
This friendly, caring group has a common bond: To live one day at a time and do the best we can every day. Stroke Support Group members encourage each other in many ways and help anyone experiencing stroke-related challenges. Guest speakers share stories and coping strategies, as well.
For more information on this group, which meets on the first and third Monday each month (except holidays), please call Lois at 602-331-8432.