Stroke Team Takes the Immediate Action Patients Need

May 2, 2008

If you think there is any possibility that you are having a stroke, call 911 immediately or go to the emergency room and make sure your symptoms are evaluated.

That’s the unanimous advice of the expert stroke team at Floyd Memorial. “We can’t overstate the urgency,” said Neurologist Joseph Seipel, MD. “It used to be that it didn’t matter how fast you got to the hospital because there was no therapy that would make a difference in the outcome. Now, however, we have clot-busting drugs with the potential to reverse stroke symptoms. But you can only use the medicine within a three-hour window after the onset of symptoms because of the increasing danger of hemorrhage. If you wait, your opportunity is gone and damage to the brain becomes permanent.”

Memorize These Stroke Symptoms Today

Steven R. Pahner, MD, emergency medicine physician, listed the symptoms of stroke, which include the following:

  • Sudden difficulty speaking or understanding speech
  • Sudden confusion
  • Sudden onset of weakness, especially on one side
  • Sudden sensory loss, such as numbness or tingling in an arm or leg
  • Sudden onset of dizziness or loss of balance
  • Sudden loss of vision or onset of double vision
  • Sudden onset of severe headache without known cause

“If you have any of these symptoms, get to the hospital or call 911 immediately,” cautioned Dr. Pahner. “If you wait, you could lose that three-hour window of opportunity to open the artery and have a chance to reverse the symptoms.”

The Anatomy of a Stroke

“A stroke implies that part of the brain is dying,” explained Dr. Seipel. “Untreated, it can result in permanent neurological dysfunction, such as blindness or the inability to walk or talk.” There are two basic types of strokes; ischemic and hemorrhagic. Both deprive the brain of blood that provides the oxygen it needs. About 83 percent of all strokes are ischemic, caused by blockage in an artery that supplies blood to the brain. The other type of stroke is hemorrhagic, and occurs when a blood vessel in the brain ruptures and bleeds into surrounding tissues. The accumulation of blood compresses nearby blood vessels and deprives surrounding tissues of oxygen.

Life-Saving Intervention

Accurate diagnosis is essential because the thrombolytic, or clot-busting, drugs such as tPA that can be effective in reversing the effects of ischemic stroke can cause massive bleeding if administered to a patient having a hemorrhagic stroke. Advanced diagnostic technology such as Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiography (MRA) and Computed Tomography Angiography (CTA) aid the stroke team at Floyd Memorial in making appropriate treatment decisions.

As Dr. Seipel explained, “Treatment is not without risk, and not every patient is a good candidate for tPA. But research shows more people do well than poorly. If you get to the hospital in time, at least you give yourself the chance.” He added that he recently treated a patient whose stroke symptoms had completely resolved before he left the hospital. “The difference after treatment is not always as immediate and dramatic as it was for him, however research shows significant difference noted within two to three months of treatment compared to those not treated.”

“A man recently came to the ER within about an hour of the onset of symptoms, which included sudden difficulty speaking. We did a work-up evaluation and diagnosis with radiological testing to make sure he was a candidate for clot-busting medication, which his family elected for us to use. By the time he left the hospital, his symptoms were reversed. He had no deficit.”

-Joseph Seipel, MD
Board Certified Neurologist
Neuro Care of Southern Indiana, PSC