Acute Stroke Symptoms & Treatment
What is a stroke?
More than 750,000 new strokes are diagnosed each year in the United States. Stroke is the third leading cause of death in America and the No. 1 cause of adult disability. But 80 percent of strokes are preventable.
Strokes can be divided into two main types. A bleeding, or hemorrhagic, stroke typically results from a ruptured aneurysm or an AVM. Ischemic stroke occurs when a blood clot blocks an artery that brings blood to the brain. Deprived of oxygen, brain cells die at a rate of two million cells per minute during an ischemic stroke, increasing the risk of permanent brain damage, disability or death. Recognizing symptoms and acting fast to get medical attention can save a life and minimize disability — the need for urgent evaluation and therapy led to the creation of the REACH MUSC Program.
- Sudden numbness or weakness of the face, arms or leg — especially on one side of the body
- Sudden confusion or trouble speaking or understanding speech
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, or loss of balance or coordination
- Sudden severe headache with no known cause
Stroke Risk Factors:
- Over age 55
- African American
- Atrial fibrillation
- Family history of stroke
How are strokes diagnosed?
Upon arrival at a hospital, the first order of business is to perform a CT scan of the brain to determine if you are in fact suffering a stroke, and whether it is ischemic or hemorrhagic in nature. If the scan reveals an ischemic stroke (result of a clot), special CT scans may be performed to enable physicians to view the arteries and determine the site of the blockage. These scans will also reveal the way blood flows to the brain, information that is used to assess the presence of brain damage or if there is at-risk brain tissue that could potentially be saved (known as penumbra).
How are strokes treated?
Advances in the treatment of stroke have led to the advent of primary stroke centers, or hospitals where a group of medical professionals who specialize in stroke, work together to diagnose, treat, and provide early rehabilitation to stroke patients.
MUSC is the only Comprehensive Stroke Treatment Center in South Carolina that has a team of physicians, nurses and technologists that can diagnose, treat and care for stroke patients beyond the standard three hour window around the clock with all medical and surgical options available. Almost half of our patients are treated after eight hours with advanced techniques such as the administration of clot busting medications directly into the clot or using devices to break up or remove the clot.
In acute stroke treatment, the rule of thumb is “Time is brain." The faster treatment can be initiated, the better the chance of a successful outcome. Current FDA-approved therapies include clot-busting medications (t-PA) that can be administered intravenously (through a needle in the arm) within three hours, and sometimes up to 4.5 hrs, of symptom onset, as well as certain devices that can break up or remove the clot when used within six hours of symptom onset.
The FDA-approved devices mentioned above are only available at highly specialized stroke treatment centers or comprehensive stroke centers. Currently, these devices include the Penumbra reperfusion system and the Concentric Merci retriever. By placing these devices in specialized catheters (resembling long thin tubes) that are inserted into the body through an artery in the groin and threaded up through the blood vessels to the site of the clot in the brain, physicians can maneuver the devices to break up the clot and remove it from the body.
Following these procedures patients usually spend a few days in an intensive care unit where medical therapy, risk factor modification and early rehabilitation is started.