Stroke care: John Nasseff Neuroscience Institute
Use the FAST test to recognize and respond to the signs of stroke.
Source: National Stroke Association
More than 795,000 Americans will have a stroke — or brain attack — this year, and 133,000 cases will be fatal. Stroke is the fourth leading cause of death in the United States.
A stroke happens when blood and oxygen flow to the brain is stopped or interrupted due to a ruptured or blocked blood vessel. This can cause damage to the brain.
Through prevention, education and treatment, Allina Health is working to lower these numbers and improve a patient's chances of recovering from a stroke with fewer complications.
Sandra Hanson, MD, Stroke Program medical director for Allina Health, explains more about stroke in these short videos.
I'd like to talk to you today about an unfortunately common problem of stroke that affects many of our lives or the lives of our loved ones and can leave a number of people with significant disability. Stroke can take a couple of different forms.
The first type – hemorrhagic stroke is where a blood vessel breaks and blood escapes into the brain and does damage in that fashion.
The second type of stroke – an ischemic stroke is a situation where a blood clot forms and blocks blood flow and therefore oxygen and nutrients to a portion of the brain and does damage in that fashion.
The term TIA or transient ischemic attack is essentially the same thing, but in the case of TIA, the blood clot breaks up spontaneously and blood flow is restored quickly enough that no damage is done, so essentially a warning sign of stroke. In the case of an ischemic stroke, presenting to the emergency room early is critical. There's a period of time where the damage is not yet permanent and intervention with some type of treatment to restore blood flow can result in a better outcome and avoiding the disability of stroke.
Time is critical. It's estimated that almost two million nerve cells are lost a minute, while we're waiting for the blood flow to be restored. So it's very important that you call 911 right away with symptoms or signs of stroke.
The importance of early recognition of a stroke and acting quickly can’t be stressed enough. So in order to act quickly, we have to be equipped with an understanding of what a stroke looks like. The suddenness of onset is one of the key features. So sudden onset of numbness or paralysis or weakness on one side of the body, sudden onset of speech difficulty, confused speech or trouble understanding speech, sudden onset of visual problems in one or both eyes, sudden onset of dizziness or imbalance or incoordination or sudden severe headache could be a sign of a hemorrhagic stroke. So it’s very important to be able to recognize these symptoms early in yourself or a loved one and get help right away calling 911.
There are a number of risk factors for stroke that you should be aware of. The most common risk factors include high blood pressure, high cholesterol, diabetes, heart disease or an irregular heart rhythm called atrial fibrillation or a history of stroke or other vascular disease or smoking.
Now some of these risk factors are direct causes of stroke. For example atrial fibrillation, the irregular heart rhythm can cause you to form a clot and cause the stroke itself. Some of these are just the cause of the cause, so high cholesterol or high blood pressure can predispose you to develop plaque build up in your blood vessels and the plaque build up causes the stroke. But, the point is that some of these are modifiable and your doctor can help you with controlling, for instance high blood pressure or high cholesterol. So it’s very important to address these things with your doctor and decrease your risk of stroke.
I want to talk with you today about the treatment of ischemic stroke in the emergency room. So a stroke, an ischemic stroke is when a blood clot blocks blood flow. So the point of treatment is to dissolve or breakup that clot and restore blood flow quickly enough so that no damage is done.
So when you or a loved one would arrive to the emergency room, the first thing that would happen in most emergency rooms is something like a stroke code would occur. This is a team of people collecting to evaluate you quickly, to determine whether you're a candidate for treatment. A CAT scan will be performed, lab tests and an exam at the bedside. And if you're a candidate for treatment, the first line of treatment typically for stroke is to give a clot dissolving treatment called TPA. This works by going through your blood system, through an IV, some of it collects where the clot is, dissolves the clot and restores blood flow. If blood flow is restored quickly enough, damage that would have been done can be limited.
The second line of treatment for strokes that involve a large artery can be more mechanically disrupting the clot. In that case, a catheter or small tube is threaded through your blood system going from the groin up to, all the way up to where the blood vessel is and either mechanically disrupting the clot or dissolving the clot right, right at the site where the clot sits.
So either way these treatments are very time sensitive and it's critical that you arrive to the emergency room, in the early hours after the stroke has started in order to avail yourself of that treatment. So remember call 911 and get to the emergency room, as quickly as you can.
Stroke care locations
Telehealth brings expert stroke care close to home
Through the Allina Telehealth Network, hospitals in greater Minnesota or western Wisconsin have 24-hour access to stroke care experts.
At Allina Health, all of our hospitals are deemed stroke ready. This includes offering immediate stroke intervention and management using clot busting (thrombolytics) medications. All sites have access to stroke neurology specialists either in person or via tele-stroke 24 hours a day/7 days a week.
Four Allina Health hospitals have achieved The Joint Commission (TJC) certification as Primary Stroke Centers demonstrating a focus on performance improvement and excellence in quality indicators for optimal stroke care.
In addition to Primary Stroke Center certification, United and Abbott Northwestern Hospitals have the ability to provide advanced stroke care, including neuroendovascular interventions for emergent mechanical thrombectomy.
John Nasseff Neuroscience Institute at Allina Health
Primary stroke centers:
Stroke ready hospitals:
Stroke risk factors
Stroke signs and symptoms
Signs and symptoms of stroke may last a short time and disappear. Don't delay in getting help. A stroke is a medical emergency.
If you have any of the following, call 911 right away:
Risk factors increase your chance of having a stroke. There are two types of risk factors: those you cannot control and those you can.
Stroke risks you cannot control
The following risk factors are those you cannot control:
Stroke risks you can control
The following risk factors are those you can control:
Rehabilitation and ongoing support
Those who have limitations after a stroke find rehabilitation can help improve their function. With proper care you can regain skills and learn new ways to accomplish familiar tasks.
When you or a loved one has many medical needs, trying to determine how to get help and what services exist can be difficult. We are committed to going beyond your medical needs — making it easier to stay in control, maintain independence, have peace of mind, and enjoy life.
As one grows older, conditions like stroke can disturb the ability to function or cope. Allina Health Mental Health's Geriatric Psychiatry Program involves families as their loved ones are cared for in the safe settings of United Hospital or Unity Hospital.
What to do after a stroke
If you had a stroke, it is important that you follow your health care team's directions for medicines, healthful diet, exercise and controlling risk factors. Keep all appointments with health care providers. If you have any questions or concerns about your health, ask your doctor.
Stroke support groups
Allina Health stroke resources
Minnesota Stroke Association resources
Allina Health stroke support groups
Ongoing support groups in these Minnesota cities welcome stroke survivors and their care partners:
Courage Kenny Rehabilitation Institute offers this program specifically designed for people who have experienced a stroke, a brain injury or a movement disorder, and for their care partners.
Treating the stroke: Jay Monogue's story
An alert had been sent to the stroke team at United in advance of their arrival, so staff was ready. After an assessment by an Emergency Department physician in consultation with a stroke neurologist, Jay went to the imaging suite and underwent a CT scan.
After three brain surgeries that saved her life, and receiving inpatient rehabilitation at United Hospital, she continued her recovery at Courage Kenny Rehabilitation Institute.
Coon Rapids Firefighter Ken Boelter continues to fight one of the toughest battles of his life. A stroke paralyzed the left side of his body.
Experts at Courage Kenny Rehabilitation Institute say he's making great strides.
Richard Norvold's first clue that something was wrong was a persistent swishing noise in his left ear.
An active 73-year-old who works six days a week at his own business, Norvold was told it was probably nothing to worry about -- until he noticed his left heel was dragging.
Bailey Carlson attends physical therapy five days a week. Her hands and wrists often get tired during exercises, but she's come a long way after having a stroke when she was 16 years old.
When Jacob McLellan's parents let him go to the Minnesota state high school wrestling tournament, little did they know that this decision may have saved Jacob's life.
While at the tournament, 16-year-old Jacob had a stroke.
Painting has always been Frank Hoffman's means of intellectual and artistic expression. After suffering a stroke, he includes his artwork as a means of therapy.