Stroke is the fifth leading cause of death and the leading cause of disability for all Americans. To combat stroke and its affects, Providence provides evidence-based, comprehensive care from preventive education and screenings, to diagnosis, immediate intervention, management and rehabilitation.
The warning signs of a major stroke include:
- Sudden weakness, clumsiness or numbness of the face, arm or leg on one side of the body
- Loss of speech, or difficulty speaking (such as garbled words)
- Acute dimness or loss of vision in one eye – often described as a shade coming down over the field of vision in one eye – or loss of vision to one side out of both eyes
Act F-A-S-T when a stroke strikes:
- Face - Does the person have a facial droop? Ask them to smile.
- Arms - Is on arm weak or numb? Ask the person to raise both arms.
- Speech - Is the speech slurred? Ask the person to repeat a simple sentence.
- Time - Time for help. Call 911.
Collaboration begins when you call 911 when you experience stroke symptoms. Fast response provides timely treatment that gives the best chance for recovery and quality of life after a stroke.
"Temporary strokes" (transient ischemic attacks or TIAs) can occur days, weeks or even months before a major permanent stroke. The symptoms occur rapidly and last a relatively short period of time, usually from a few minutes to several hours. The usual symptoms are like those of a major stroke, except that the signs and symptoms are temporary, typically lasting 24 hours or less. If you experience a TIA, you may be up to nine times more likely to suffer a major stroke soon.
You can reduce your chance of suffering a stroke by gaining a greater understanding of how this condition occurs and by identifying common risk factors.
Some risk factors are genetically determined. Others simply happen naturally or are due to lifestyle. While the factors resulting from heredity or natural processes can't be changed, you can make changes in your environment or lifestyle that can decrease your risk of stroke.
The five uncontrollable risk factors include:
- African American heritage
- Family history of diabetes
- Family history of stroke
Controllable risk factors include:
- Treatable medical disorders, such as diabetes, atrial fibrillation, heart attack, high blood pressure, high cholesterol, heart disease, personal history of stroke or transient ischemic attacks (TIAs), and patent foramen ovale (or "PFO," an abnormal opening between the right and left sides of the heart)
- Cigarette smoking
- Excessive alcohol intake
- Poor diet
- Drug abuse (especially cocaine)
- Physical inactivity
- Low estrogen in women
The risk of stroke is greatly reduced by lowering your blood pressure, quitting smoking, beginning or increasing exercise, controlling medical problems, maintaining optimal weight and eating a healthy diet.
In addition to taking stock of genetic and lifestyle risk factors, your doctor may recommend further screenings. These include a medical history, physical examination and blood tests to check for high cholesterol or other conditions that may contribute to atherosclerosis.
An ultrasound examination of your carotid arteries, the blood vessels in your neck that are the primary blood supply to the brain, may also be performed to determine if there is significant disease (e.g., atherosclerosis).
When a stroke happens, every minute counts. Providence St. Joseph Health combines expertise, technology and collective collaboration to deliver fast and thorough treatment for stroke patients.
Thrombolytic or “clot busting" medication
Thrombolytic or “clot busting” medication is offered to eligible patients who are suffering an acute stroke.
Most strokes are caused by a blood clot that blocks healthy blood flow through an artery in the brain. These strokes are called ischemic strokes because the brain tissue becomes injured and starts to die from the reduced blood flow to the area. This causes deterioration.
Thrombolytics are used to dissolve these obstructing blood clots quickly. This is the “clot busting” effect of the medication. The faster we can administer this medication, the better the chances are of recovering salvageable brain tissue.
Recombinant tissue plasminogen activator (rt-PA) is a genetically engineered form of t-PA (t-PA is a natural occurring protein involved in the breakdown of blood clots). This drug only works if it is given intravenously within three hours of the onset of stroke symptoms. It poses risks to patients who are taking blood thinners or who have recently undergone surgery or trauma.
Endovascular intervention or “clot retrieval”
Endovascular intervention or “clot retrieval” is a specialty procedure where a specialized interventional physician retrieves a blood clot from an artery in the brain through catheter insertion from the groin.
Along with rt-PA, endovascular intervention such as “clot retrieval” has become the standard of care for large-vessel occlusive strokes.
Coiling and clipping of brain aneurysms
Coiling and clipping are procedures to repair cerebral aneurysms.
Not all strokes are caused by clots. Many bleeds, such as subarachnoid bleeds, are caused by ruptured aneurysms. Once the aneurysm is detected, our specialized physicians act fast to secure the aneurysm with coiling or clipping procedures.
Coiling allows the interventionist to fill the aneurysm with a coiling type of material so that it no longer fills by circulation. This inhibits the aneurysm from growing or bursting.
The other procedure, clipping, is a procedure where the aneurysm is literally clipped extravascularly at its base. This procedure closes off the opening to the aneurysm so that it does not grow or burst.
Rehabilitation is an ongoing process. Your progress depends on your condition after the stroke, your rehabilitation team, support of family and friends, and how soon you begin rehabilitation. Depending on your condition, your care team may include licensed occupational, physical and speech rehabilitation specialists who each share the goal of your optimal functioning and restoration.
Because of advances in treatment as well as rehabilitation, stroke victims' potential for recovery is more hopeful than ever before. Providence is committed to working with patients and their loved ones to create a therapeutic plan designed to help the individual enhance health, regain independence and achieve a better quality of life.