For the "three-hour window of treatment," the clock starts ticking the moment signs of a stroke first appear. Most strokes are caused by a blockage in an artery in the brain, and if a patient arrives at a stroke center within three hours of the onset of symptoms, doctors have several treatment options that can offer dramatic results.
Corina Thomas went to Loyola immediately after waking up with a severe headache and numbness on her left side. She had arrived in time to receive tPA, an intravenous clotbusting drug, to dissolve the blockage in her brain. Corina recovered completely.
"Although we can offer treatment for several hours, research shows that earlier is better," said Rima Dafer, MD, FAHA, associate professor of neurology and neurological surgery, Loyola University Chicago Stritch School of Medicine (Stritch), who specializes in stroke care.
For select patients who don't respond to tPA, Loyola can offer a novel procedure to restore blood flow to the brain. When another stroke patient, Bobbie Laird, experienced only slight improvement from tPA, she was taken to the catheterization lab to extract the blood clot. John Whapham, MD, assistant professor of neurology and neurological surgery, Stritch and neurointerventional program director, inserted a catheter device in an artery in Bobbie's groin and guided it into the blocked blood vessel. Dr. Whapham deployed a tiny agitator to break up the clot, and then suctioned the debris through a thin tube. Bobbie also made a nearly complete recovery.
Many stroke centers do not have the expertise to offer this treatment, but Dr. Whapham has performed this procedure on hundreds of stroke patients. "There has been a huge evolution in catheter-based devices over the last five years," Dr. Whapham said, "yet the basic truth remains: Time is brain. You have to act even faster than you do with a heart attack."
At Loyola stroke patients are monitored for potentially serious complications in an intensive care unit. There, trained vascular neurologists work to identify why the stroke occurred and determine how to prevent another stroke in future. With the benefit of the treatment team and a multi-disciplinary rehabilitation team of therapists, physicians and support group members, many patients, like Corina and Bobbie, can enjoy years of healthy living.
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FAST Action Saves Lives
Stroke is the third leading cause of death and the leading cause of long-term disability. Managing risk factors can save thousands of lives and reduce the severity of disabilities.
"There are many things people can do to lower their risk for stroke," said Rima Dafer, MD, FAHA, associate professor of neurology and neurological surgery, Loyola University Chicago Stritch School of Medicine. "If you keep your blood pressure under control, manage your diabetes, quit smoking and lower your cholesterol, you will be less likely to have a stroke. If you are physically inactive, you can start exercising. And if you have an irregular heartbeat, seek medical care."
Everyone must be aware of the signs and symptoms of stroke. Dr. Dafer says that "thinking FAST" about stroke symptoms can save lives:
- Face droops or looks different on one side
- Arm (or leg) loses feeling or body becomes imbalance
- Speech becomes garbled or difficult
- Time is crucial - note when the symptoms started; call 911 immediately
LOYOLA UNIVERSITY HEALTH SYSTEM
