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Our primary stroke center: what it means to you

When someone is having a stroke, they need prompt emergency medical care. During a stroke blood supply to the brain is cut off or disrupted, causing part of the brain to go without the oxygen-rich blood it needs. The longer the brain goes without blood, the greater the chance a disability will occur.

Medical research has found that patients who received tPA within three hours of the first stroke symptoms were at least 30 percent more likely to recover with little or no disability after three months. When a person is having a stroke, doctors must first determine whether the stroke is caused by a clot (ischemic stroke) or by a ruptured blood vessel (hemorrhagic) before tPA can be used. This is because tPA can only be used for ischemic strokes, which account for about 87 percent of all strokes.

The Brain Attack Coalition, a group of 14 national organizations including the American Academy of Neurololgy, the American Association of Neurological Surgeons, the American College of Emergency Physicians, the American Society of Neuroradiology and the American Stroke Association, developed joint recommendations for hospitals to create stroke care centers as a way to improve the quality of care for stroke patients.

The concept for the stroke care centers is similar to that of a trauma center combining the resources of a number of specialties to quickly evaluate and treat patients with complex medical needs. Like a trauma center, the stroke center team works closely with local emergency medical services so that proper care can begin before the patient arrives at the hospital.

The stroke team includes physicians such as neurologists or neurosurgeons who specialize in the care of strokes. Nurses from the hospital’s emergency department or intensive care centers also are part of the stroke team. The team is available around the clock to respond when a patient with stroke symptoms comes to the hospital.

The goal of a stroke team is to promptly assess the patient’s condition and order the tests needed to diagnose the type of stroke involved. The team also works to stabilize the patient’s blood pressure, heart rate and other vital functions. If the tests show that the patient’s stroke is the result of a blood clot blocking a vein in the brain, then tPA can be given to help break up the clot. The team’s goal is to begin tPA within three hours of the first symptoms of a stroke.