DISORDERS & TREATMENT

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Stroke Patient Story


Stroke Diagnosis Key to Limiting Damage, Restoring Function

Bob well remembers the day when his left side suddenly became weak. I was talking on the phone and I couldn't hang up the receiver. I knew something was seriously wrong.

Bob was lucky. He was rushed to Kettering Medical Center and immediately seen by the WKNI Stroke Team, a unique group of highly skilled and experienced neurologists, neurosurgeons, radiologists, pharmacists, technicians, and neuroscience and emergency nurses.

The Stroke Team, which is on-call 24/7, had been notified via a high-speed communication system that Bob was on the way and was experiencing symptoms of a stroke.

A stroke can occur in two ways: when a blood clot blocks a blood vessel or artery and when a blood vessel breaks, interrupting the flow of blood to the brain. Being able to quickly and accurately diagnose which type of stroke a patient is having is critical because they are treated in vastly different ways.

The WKNI Stroke Team can evaluate the individual who arrives in the Emergency Department within less than three hours of symptom onset, or last known normal. If a stroke is caused by a blockage, the Stroke Team must determine if the patient fits the recommended criteria and is safe to receive a clot-buster drug, t-PA. When initiated within this three-hour window, t-PA may limit the size of the stroke and has the potential to reverse stroke symptoms. Kettering Medical Center participated in research trials in the 1990s that demonstrated one third of the patients who received t-PA did better in six months compared to those who did not receive the drug.

Because of the speed, coordination and expertise of the WKNI Stroke Team, they have been able to administer t-PA to patients at a rate of approximately 10%, nearly double national average. It takes a lot to get patients treated within three hours of first experiencing symptoms, explains Jeanne Robinson, MS, CNRN, Kettering's stroke program clinical coordinator and case manager, who leads the WKNI Stroke Team. You have to have an experienced team and process in place and always be ready.

Giving t-PA correctly to someone with a blockage can be nothing short of lifesaving and may restore function so the individual may continue to be independent. But, giving it to someone with a bleeding blood vessel stroke is deadly. Many hospitals can't administer t-PA because they don't have a team in place like Kettering's.

It can be extremely difficult to diagnose strokes, explains Robinson. It takes a lot of expertise in determining not only what kind of stroke it is but also if this is a stroke mimic, something that acts like a stroke but isn't one.

The Stroke Team that met Bob in Kettering's ER had one goal in mind: diagnose him immediately in order to restore function and limit brain damage. Within less than an hour of his symptoms, the team diagnosed him as having a broken blood vessel, which was bleeding in his brain. Treatment with t-PA was not an option, since this treatment could increase the bleeding. They were able to quickly stabilize Bob, and soon he was transferred to the Intensive Care Unit for recovery.

Today, Bob has regained nearly full function of his left side. Although he still walks with a cane, he's back at work, driving, and traveling independently. He credits the stroke team at Kettering for his success.

The fact that the team was waiting as I arrived, and zipped me right through to a diagnosis was incredible. It is a blessing to be in a place where they have a stroke team ready to meet the needs at any moment.