Stroke, also known as brain attack, cerebrovascular accident, or CVA, is a medical emergency requiring swift transportation to the nearest medical center and immediate medical treatment by the stroke team. We like to say time is brain, because the quicker we can act to stop the stroke, the more brain function we can save, decreasing complications, disability, and the risk of death. Truly, every minute counts!
If you or a loved one comes to Cayuga Medical Center with signs of a stroke, you can take comfort in knowing that your medical center is a designated Primary Stroke Center. This means that we meet the high standards of diagnosis and treatment prescribed by the American Stroke Association and the New York State Department of Health. You will find yourself instantly at the center of a multidisciplinary group of emergency physicians, licensed independent practitioners, nurses, neurologists, radiologists, and neurosurgeons.. These clinicians are available to respond 24/7 in the Emergency Department for the evaluation and treatment of stroke patients.
If you are admitted to Cayuga Medical Center for stroke, you will have access to intensivists, who specialize in critical care medicine and hospitalists, who specialize in hospital-based internal medicine. If you have other conditions besides stroke that need treatment, such as heart disease, you may also see a sub-specialist, such as a cardiologist. Other clinical experts that may help care for you include physical therapists, occupational therapists, speech-language pathologists, dieticians, ultrasound technicians, palliative care specialists, case managers, chaplains, and social workers. In this way, Cayuga Medical Center can focus on treating you as a whole person and helping you achieve your best possible quality of life.
The Benefits of Choosing a Designated Stroke Center.
Stroke is the fifth leading cause of death in the United States and the leading cause of disability: of those who survive, 90 percent continue to have some sort of neurological deficit. Studies published in the Journal of the American Medical Association have shown that patients treated at hospitals with Stroke Centers have reduced mortality rates, fewer complications, improved long-term outcomes, and increased patient satisfaction.
A Stroke Alert at Cayuga Medical Center calls the clinical stroke team into action, at which point things happen very quickly. In the management of acute stroke, the pressing issue is time. If you arrive within four and a half hours of when you were last known to be well, you may be able to receive intravenous thrombolytic medicine to dissolve the clot blocking blood flow in the brain. Even within that window, the faster you can receive treatment, the better your outcome is likely to be. However, even beyond that four-and-a-half-hour window, there may still be options for treatment, so do not hesitate to call 9-1-1 if you think you or a loved one is having a stroke.
When you call 9-1-1 for a suspected stroke, local emergency medical services (EMS) responders start the process with their assessment in the field. EMS responders are critically important to the stroke process because their assessments, interventions, and particularly their pre-notification prior to arrival at the hospital save precious time. As soon as the ambulance calls the Emergency Department, the response begins. The first step in the stroke process is to immediately receive a computed tomography (CT) scan of the brain. Therefore, our CT imaging technologists prepare the CT scanner and call the radiologist to put him or her on stand-by alert. Everyone else on the stroke team assembles in the Emergency Department to be ready and waiting at the door to receive the patient.
Types of Stroke and Diagnostic Imaging
There are two types of stroke. The most common type is ischemic stroke, which is caused by a clot and/or vessel narrowing that blocks blood flow in the brain. The less common but more dangerous type is hemorrhagic stroke, which is caused by bleeding into the brain often from an aneurysm (a weakness causing a bubble in an artery wall) that leaks or ruptures. As soon as the initial CT images are taken, they are transmitted to the radiologist for immediate interpretation. By examining a CT scan of the brain, a radiologist candetermine if the patient is bleeding in the brain (hemorrhagic). If no bleeding is detected and the patient is eligible, ischemic strokes can be treated with the thrombolytic medication that may dissolve the clot and restore blood flow in the brain. Additional brain imaging studies can be helpful to determine the extent of the impact of the stroke on the brain.
How to Recognize a Stroke
Signs and symptoms of stroke usually occur suddenly. An acronym to help you remember not only the symptoms, but what to do is BE FAST:
- Balance: Trouble walking, dizziness, or loss of balance or coordination
- Eyes: Trouble seeing from one or both eyes
- Face: One side of the face is drooping and/or numb
- Arms: Numbness or weakness of the arm, leg, or one side of the body
- Speech: Confusion, trouble speaking (slurred speech or forming words), or understanding
- Time: to call 9-1-1
- The other symptom that may be present is a severe, unexplained headache, especially one that comes on quickly
If you or a family member has any of these symptoms, call 9-1-1 immediately. Do not try to drive yourself or the patient to the hospital – your symptoms could get worse while you’re driving. Also, if you call 9-1-1, your care will start that much sooner: the hospital will know you are coming before you arrive and can get the team ready to care for you. Even if your symptoms go away, you should still come to the hospital. You may be having a transient ischemic attack (TIA), which is your body’s way of warning you that you might have a stroke in the future. If this is the case, there are still steps that you and your healthcare providers can take to try and prevent a future stroke.
Risk Factors for Stroke You May Reduce With Your Doctor’s Help
- High blood pressure
- Tobacco use
- Diabetes and blood sugar control
- Carotid and other artery (vascular) disease
- Irregular heart rhythm (atrial fibrillation, a-fib)
- Substance use disorder
- Transient ischemic attacks (TIAs, warning strokes, mini-strokes)
- Certain blood disorders
- High blood cholesterol
- Physical inactivity and obesity
- Excessive alcohol use
Stroke Team Medical Director
The Primary Stroke Center at Cayuga Medical Center is under the direction of Dr. Caelyn Bellerose, a board-certified emergency medicine physician.