Science
Stopping Strokes: Baptist Health Experts Explain Timely, Comprehensive Therapies
7 min. read
The data is striking but everyone needs to be reminded: Every 40 seconds, someone in the U.S. has a stroke, and someone dies of stroke every three to four minutes, according to public health officials. May is Stroke Awareness Month.
Stroke is the No. 5 killer and a leading cause of disability in the U.S. And getting treated quickly – within a tight window of time from onset of symptoms -- with the latest advanced care is vital. When you choose Baptist Health for stroke care, multi-disciplinary teams are dedicated to a rapid diagnosis, innovative treatment and a comprehensive recovery.
Baptist Health Brain & Spine Care brings together two institutes — Baptist Health Miami Neuroscience Institute and Marcus Neuroscience Institute -- with dedicated stroke teams. They are led by Felipe De Los Rios La Rosa, M.D., stroke program director at Baptist Health Miami Neuroscience Institute, and Brian Snelling, M.D., stroke program director at Marcus Neuroscience Institute, part of Baptist Health, at Boca Raton Regional Hospital.
)(Watch now: Hear from Felipe De Los Rios La Rosa, M.D., stroke program director at Baptist Health Miami Neuroscience Institute, and Brian Snelling, M.D., stroke program director at Marcus Neuroscience Institute, part of Baptist Health.)
Baptist Hospital, in partnership with Miami Neuroscience Institute, was the first hospital in South Florida certified as a Comprehensive Stroke Center by The Joint Commission. This is the nation’s highest level of stroke accreditation.
“We have all the tools to be able to treat a stroke so that we can try to prevent brain damage happening in the first place,” said Dr. De Los Rios. “And we have all the resources as far as rehabilitation goes, so that the chances for recovery are maximized and they can happen as soon as possible.”
The standard of care for treating stroke patients at Baptist Health is providing individualized care for each patient, said Dr. Snelling. “Whether that's thrombolytic therapy (clot dissolving medication) or mechanical thrombectomy (minimally invasive surgery) to actually retrieve a clot. We treat every patient individually and assess them, and decide what's the best care for that patient. And we deliver what we know based on the best evidence to give them the best chance at a full recovery.”
While recent trends have pointed to a troubling increase of strokes among young adults, the majority of people carry an increasing risk as they age. Nonetheless, anyone can have a stroke at any age. An ischemic stroke occurs when a vessel supplying blood to the brain is obstructed. It accounts for about 87 percent of all strokes. Hemorrhagic strokes represent the remaining 13 of stroke cases. They occur when a weakened vessel ruptures and bleeds into the surrounding brain.
What many people don’t realize is that you can prevent, control or treat several risk factors for stroke. Those modifiable risk factors include high blood pressure, diabetes, obesity, physical inactivity, high cholesterol and smoking.
Another fact that may not be well-known: Strokes are more common in women.
“Stroke can present in very different ways,” explains Dr. Del Los Rios. “First of all, it's important to understand that it's a very common condition. One out of four women will have a stroke at some point in their lives, and one out of five people overall. It's very common.
Recognizing Common Stroke Symptoms — Known By The Acronym F.A.S.T.
It’s vitally important to recognize the signs and symptoms of stroke and understanding the acronym F.A.S.T. (see below for more details) is just as relevant as ever.
“When someone is having a stroke, the first thing that you would notice is that there's a difficulty to do things,” said Dr. De Los Rios. “If anyone has any difficulties with face movement, or arm or leg weakness, or their speech sounds slurred, or they can't understand what you're saying -- then the T is for time because you really have to call 911 and get to the closest stroke-capable center because there are some therapies that can be administered to prevent damage from the stroke.”
Adds Dr. Snelling: “Seeking care immediately is of vital importance. If you are having a stroke, or if a friend or a loved one is having a stroke, at our hospital, we are in close communication with our EMS colleagues, and they are often calling us from the field when they identify patients who they think are having a stroke. They can provide us that patient's information and we're able to meet them at the hospital.”
Stroke Response Teams Ready to Treat Patients Quickly
The best chance of recovery from a stroke – including prevention of permanent disability – is to be treated as fast as possible but within 24 hours after the onset of symptoms from an ischemic stroke, the most common.
“If someone is able to come to the hospital within 4.5 hours of when their symptoms started, we might be able to give them a specific medication that destroys blood clots,” said Dr. De Los Rios. “We call those thrombolytics. Within 24 hours from when their symptoms started we might be able to do endovascular neurosurgery and go within the artery to remove the blood clots so that we can try to minimize the damage caused by that stroke.”
At Marcus Neuroscience Institute, stroke response teams are also at the ready around the clock.
“We actually have a unique role where we have stroke clinicians who are specially trained nurses available 24/7 at our hospital,” explains Dr. Snelling, referring to Boca Raton Regional. “They meet the patients who are having strokes at the door and they facilitate their entire care from arrival till eventually where they get to where they're supposed to be and receive the treatment that they're supposed to receive.
“In addition, we have a great relationship with our local EMS colleagues. Oftentimes, they give us a heads-up when they're bringing a patient to us, so we're actually able to meet them. Me, myself, and my team are able to meet them at the door to provide that care as quickly as possible.”
Advances in Stroke Care Continue to Evolve
“Technology has greatly influenced stroke care,” explains Dr. De Los Rios. “We now have new medications that we can use to try to dissolve blood clots to prevent damage from the stroke in the first place. We have new technology to try to identify if someone is having a stroke, where the stroke is, what type of arteries are being involved. And the use of artificial intelligence (AI) has also revolutionized stroke care. AI is able to tell much quicker if there is a stroke, if one of the biggest arteries is being blocked, so that we can select patients for specific treatments.”
When a patient arrives in the ER with stroke symptoms, a team consisting of emergency room physicians, neurologists and neuroradiologists diagnose the condition as quickly as possible and treat it with the most advanced clot-busting medications, such as a tissue plasminogen activator, or tPA. In addition to this treatment, neurologists will work closely with other specialists to use the latest treatment techniques and devices, including endovascular treatment, for removing blood clots or plaque from inside arteries.
Dr. Snelling explains that advances in stroke treatments is including more patients would could benefit from thrombolytic therapy, or the use of medications to destroy blood clots or prevent new blood clots from forming.
“The future of stroke care is changing in a few ways,” said Dr. Snelling. “One is further identifying patients who we think would benefit from stroke acute treatment, meaning patients who would further benefit from having a clot retrieval procedure or would benefit from having some thrombolytic therapy. A lot of that is driven by artificial intelligence. It seems like every year there are new trials that are completed that show there's more and more groups of patients who are previously excluded from these treatments who we know would find benefit.”
F.A.S.T. Signs of a Stroke
Here are the top signs of a stroke and other symptoms, according to the American Stroke Association:
F – Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
A – Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S – Speech Difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
T – Time to call 9-1-1: If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared.
Other Sudden Stroke Symptoms
NUMBNESS or weakness of face, arm, or leg, especially on one side of the body;
CONFUSION, trouble speaking or understanding speech;
TROUBLE SEEING in one or both eyes;
TROUBLE WALKING, dizziness, loss of balance or coordination;
SEVERE HEADACHE with no known cause.
Healthcare that Cares
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