Rapid Stroke Treatment

Each year, approximately 600,000 Americans will suffer a stroke and about 160,000 of them will die. In fact, someone suffers a stroke every fifty-three seconds, making stroke a leading cause of adult disability as well as the third-leading cause of death nationwide.

A stroke, also referred to as a cerebral vascular accident (CVA) or a brain attack, is an interruption in the flow of blood to cells in the brain. When the cells in the brain are deprived of oxygen, they die. A stroke occurs when a blockage in an artery prevents blood from reaching cells in the brain or an artery ruptures inside/outside the brain, causing a hemorrhage.

Forty percent of the public doesn’t know that a stroke occurs in the brain. More than 70 percent of seniors don’t know the warning signs of a stroke. Many don’t even know that stroke should be treated with the same urgency as a heart attack and that every second is critical to patient care, survival and subsequent quality of life.

Types of Stroke

  • Ischemic
    Caused by build-ups of fatty deposits on the inside of an artery wall which then becomes completely clogged. Ischemic strokes account for eighty percent of all strokes suffered. Some ischemic strokes are preceded by stroke-like symptoms called transient ischemic attacks (TIAs). These may occur months before the stroke. The loss of vision in a TIA may be described as a feeling that a shade is being pulled down over your eyes. The symptoms are usually temporary and improve within 10 to 20 minutes.
  • Hemorrhagic
    These occur when an artery inside the brain ruptures or when an aneurysm at the base of the brain bursts. Twenty percent of all strokes suffered are hemorrhagic strokes. Symptoms more specific to this type of stroke include headache, nausea and vomiting, neck stiffness, seizures, sudden changes in mental state and lethargy. Hemorrhagic strokes usually occur in the daytime and during physical activity. The symptoms typically begin very suddenly and evolve over several hours.

Detection and Diagnosis

  • Cerebral Computed Tomography (CT) Scan
    The first and most important test after a stroke is a CT scan, which is a series of X-rays of your brain that can help identify whether there is bleeding. This test will help your doctor determine whether the stroke is ischemic or hemorrhagic.
  • Magnetic Resonance Imaging (MRI) Scan
    An MRI is a test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. In many cases, MRI gives information that cannot be seen on an X-ray, ultrasound, or computed tomography (CT) scan. An MRI can determine the amount of damage to the brain and help predict recovery.
  • Cerebral Angiography
    The gold standard test used to visualize the blood vessels which supply the brain. An angiogram is considered minimally invasive and is performed through the artery in the leg. A small tube (catheter) is navigated with X-ray guidance to the blood vessels in the neck. X-ray pictures are then obtained of the blood vessels in the neck and brain. An angiogram helps to identify blockages that cause ischemic stroke. This test also identifies aneurysms and arteriovenous malformations, which cause hemorrhaghic stroke. An angiogram can help to lay the groundwork for treatment.

Treatment Options

  • For an ischemic stroke
    If your stroke is diagnosed within three hours of the start of symptoms, you may be given a clot-dissolving medication called tissue plasminogen activator (t-PA), which can increase your chances of survival and recovery. However, if you had a hemorrhagic stroke, use of t-PA would be life-threatening. If IV t-PA doesn’t work, t-PA and other clot-dissolving agents can be delivered directly to the area of blockage with the angiogram technique and very small catheters. If these medications don’t work, the clot can potentially be removed with fine-grasping instruments or the blocked vessel can be re-opened with stents.
  • For a hemorrhagic stroke
    Initial treatment of a hemorrhagic stroke is difficult. Efforts are made to control bleeding, reduce pressure in the brain, and stabilize vital signs, especially blood pressure. There are few medications available to treat hemorrhagic stroke. Surgery generally is not used to control mild to moderate bleeding resulting from a hemorrhagic stroke. However, if a large amount of bleeding has occurred and the person is rapidly getting worse, surgery may be needed to remove the blood that has built up inside the brain and to lower pressure inside the head. If bleeding is due to a ruptured aneurysm, whether surgery can be done depends on the location of the aneurysm and the person’s condition following the stroke. Surgery can involve clipping the aneurysm in an open-brain procedure. Another option is sealing the aneurysm with coils delivered through the angiogram technique. This is the less invasive option, but is not yet suitable for all aneurysms.

Prevention

Taking the following steps can help you control risk factors and other medical conditions that could lead to a stroke:

  • Have regular medical checkups. Work with your doctor to control your high blood pressure. This is especially important if you also have diabetes.
  • Become more active. The more physically active you are, the greater the reduction in risk. Exercise can also help raise HDL (“good”) cholesterol levels in your body, which also reduces the risk of stroke.
  • Get tested for high cholesterol, heart disease (especially atrial fibrillation), diabetes, or disorders that affect your blood vessels.
  • Don’t smoke. If you do smoke, quit. Daily cigarette smoking increases the risk of stroke by two times.
  • Take cholesterol-lowering medications called statins if you have high cholesterol or have had a heart attack, TIA, or stroke
Vascular Surgery Rapid Stroke Treatment GW Hospital
Vascular surgeons at GW hospital use a patient-centered approach and new, minimally invasive procedures to help promote excellent outcomes and rapid recovery.
Stroke Rehabilitation Rapid Stroke Treatment GW Hospital
The Acute Rehabilitation Team at GW hospital treats patients with the goal of providing the skills they need to live as independently as possible after leaving our facility.
This Draft Has Sidebar Blocks
Sidebar Block 1
Awards and
Accreditations

Primary Stroke Center by the Joint Commission
The Joint Commission's Certificate of Distinction for Primary Stroke Centers recognizes centers that make exceptional efforts to foster better outcomes for stroke care. Achievement of certification signifies that the services you provide have the critical elements to achieve long-term success in improving outcomes. It is the best signal to your community that the quality care you provide is effectively managed to meet the unique and specialized needs of stroke patients.

2011 Gold Plus Get With The Guidelines Award
The George Washington University Hospital has received the American Stroke Association’s Get With The GuidelinesSM–Stroke (GWTG–Stroke) Gold Plus Award. The award recognizes the hospital’s commitment and success in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations.

Sidebar Block 2
Stroke
Risk Factors
  • High blood pressure
  • Diabetes
  • High cholesterol
  • Coronary artery disease
  • Smoking (including second-hand smoke)
  • Heavy alcohol usage
  • Physical inactivity
  • Being overweight
  • Use of birth control pills, anticoagulants, and steroids
  • Hormone replacement therapy
  • Use of cocaine and other illegal drugs
  • Heart conditions such as atrial fibrillation, endocarditis, and cardiomyopathy
Sidebar Block 3
Stroke
Symptoms

Warning signs of stroke may include a combination of the following symptoms:

  • Sudden numbness or weakness of the face, arm or leg, particularly when it happens on one side of the body
  • Confusion, trouble speaking or understanding others
  • Vision problems in one or both eyes,such as dimness, blurring, double vision, or loss of vision
  • Loss of balance or coordination, dizziness and trouble walking
  • Severe headache with no known cause
Sidebar Block 4

 

The George Washington University Hospital is owned and operated by a subsidiary of Universal Health Services, Inc.(UHS), a King of Prussia, PA-based company, that is one of the largest healthcare management companies in the nation.          

The George Washington University Hospital

900 23rd St., NW
Washington, DC 20037
202-715-4000

PRIVACY POLICY / HIPAA STATEMENT / PHYSICIAN DISCLAIMER
© 2014 The George Washington University Hospital. All rights reserved.

Note:The information on this Web site is provided as general health guidelines and may not be applicable to your particular health condition. Your individual health status and any required medical treatments can only be properly addressed by a professional healthcare provider of your choice. Remember: There is no adequate substitution for a personal consultation with your physician. Neither The George Washington University Hospital , or any of their affiliates, nor any contributors shall have any liability for the content or any errors or omissions in the information provided by this Web site.            

The information, content and artwork provided by this Web site is intended for non-commercial use by the reader. The reader is permitted to make one copy of the information displayed for his/her own non-commercial use. The making of additional copies is prohibited.