Treating Stroke – Speed Counts at Parker Adventist Hospital
In the case of a stroke emergency, Parker Adventist Hospital has a rapid response procedure available 24 hours a day, 7 days a week:
- When a stroke alert is activated, the emergency department at Parker Adventist Hospital receives pre-notification on a designated EMS phone line and activates a "stroke alert" within the hospital. This alert calls all needed medical personnel to the emergency department in preparation to receive the incoming patient.
- An immediate physician evaluation is followed by a CT scan of the brain to determine if the stroke symptoms are from a clot in a blood vessel or from bleeding in the brain. Our emergency department is equipped with a CT scanner to ensure quick access to brain imaging. Parker Adventist Hospital has policies in place that follow the Joint Commission and American Stroke Association guidelines to ensure all patients with stroke symptoms receive a CT scan within 25 minutes of arrival at the hospital.
When a CT scan confirms a blockage or bleeding in the brain, a 24/7 on-call neurologist provides expert consultation and makes recommendations for treatment. Neurosurgeons also are available 24/7 for patients with bleeding in the brain.
How are Strokes Treated?
Rapid and accurate diagnosis of the kind of stroke and the exact location of its damage is critical to successful treatment. A good quality CT scan of the head being performed and interpreted immediately is the next important step after calling 9-1-1. Such technical advances as the use of the operating microscope (microsurgery) and the surgical laser have made it possible to treat stroke problems that were thought to be inoperable a few years ago.
- Ischemic stroke is treated by removing the obstruction and restoring blood flow to the brain. One treatment for ischemic stroke is the FDA-approved drug, tissue plasminogen activator (tPA), which must be administered within a three-hour window from the onset of symptoms to work best. Unfortunately, only three to five percent of those who suffer a stroke reach the hospital in time to be considered for this treatment. The earlier tPA is administered the better the reversible outcomes of disability.
- Hemorrhagic stroke often requires surgery to relieve intracranial (within the skull) pressure caused by bleeding. Surgical treatment for hemorrhagic stroke caused by an aneurysm or defective blood vessel can prevent additional strokes. Surgery may be performed to seal off the defective blood vessel and redirect blood flow to other vessels that supply blood to the same region of the brain. One type of hemorrhagic stroke effects younger adults (35 - 50 yrs) that have no risk factors and are in otherwise good health. This sub-arachnoid hemorrhage is best identified by a sudden onset of "the worse headache of your life" - requiring urgent neurosurgery to prevent death.
- Endovascular treatment involves inserting a long, thin, flexible tube (catheter) into a major artery, usually in the thigh, guiding it to the aneurysm or the defective blood vessel, and inserting tiny platinum coils (called stents) into the blood vessel through the catheter. Stents support the blood vessel to prevent further damage and additional strokes.
- The Merci Retriever, approved recently by the FDA, is a corkscrew-shaped device used to help remove blood clots from the arteries of stroke patients. A small incision is made in the patient's groin, into which a small catheter is fed until it reaches the arteries in the neck. At the neck, a small catheter inside the larger catheter is guided through the arteries until it reaches the brain clot.
- Another device, the Penumbra®, essentially acts like a tiny vacuum cleaner to suction the clot out of the artery.