Stroke
Phone: 651-326-3415

Thanks to new treatments and technology, stroke survivors have a better chance at recovery than ever before. Our stroke program offers a team of professionals who provide expert care throughout treatment, recovery and rehabilitation. After a stroke, our goal is to help each patient return to the highest quality of life, as quickly as possible.

Primary Stroke Center Certification
St. Joseph's is one of three HealthEast hospitals that hold a Gold Seal of Approval for stroke care by The Joint Commission.

To earn the certification, we demonstrated how our program follows national standards and guidelines that can greatly improve outcomes for stroke patients.

In addition to St. Joseph's, Primary Stroke Center Certification was awarded to:

• St. John's Hospital
• Woodwinds Health Campus

HealthEast is proud to be the first multi-site health care system in Minnesota to receive this distinction.

What is a stroke?
A stroke occurs when a blood vessel that brings oxygen and nutrients to the brain becomes clogged or bursts, stopping the blood supply to a portion of the brain.

When blood can't reach an area of the brain, abilities and functions controlled by that part of the brain might be impaired or lost. If not treated immediately, a stroke can lead to brain damage and disability.

Unlike a heart attack, symptoms of a stroke may not be painful. And often, the warning signs are easy to explain away. But symptoms of a stroke (or "brain attack") should be taken just as seriously. It's critical to recognize the warning signs and and call 911 immediately.

Risk factors
While some risk factors for stroke can't be controlled (like gender and age), many can. To see if you're at risk for a stroke, click here.

Education

Brain Aneurysm Support Group

Related links

National Brain Aneurysm Center

Bethesda Hospital

American Stroke Association

National Stroke Association

Warning signs of stroke

During a stroke, quick treatment is important! Recognizing the warning signs and symptoms is critical because, during a stroke, "time is brain."

If you experience any or all of the following symptoms, call 911 immediately!

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  
  
• Sudden confusion, trouble speaking or understanding
  
  
• Sudden difficulty seeing in one or both eyes
  
  
• Sudden trouble walking, dizziness, loss of balance or coordination
  
  
• Sudden, severe headache with no known cause

Types of stroke

Ischemic stroke

An ischemic stroke occurs when an artery in the brain becomes blocked or clogged, cutting off the blood flow to a portion of the brain. There are two different types of ischemic stroke:

Thrombotic stroke - occurs when an artery in the brain narrows, allowing a blood clot to clog the artery and cut off blood flow. This is the most common kind of stroke. Signs usually appear suddenly and increase over hours. Thrombotic strokes often happen at night or the first thing in the morning.

Embolic stroke - is caused by a blood clot that breaks free from an artery or from the heart and flows through the blood stream until it reaches an artery too small for it to pass through. Signs and symptoms depend on the area of the brain that is blocked.

Hemorrhagic stroke

A hemorrhagic stroke can occur when there is bleeding in the brain. Bleeding can be caused by a blood vessel bursting (due to high blood pressure) or a blood vessel abnormality, such as an aneurysm. An aneurysm develops when a point in the wall of an artery (a blood vessel that carries blood away from the heart) weakens. When this happens, blood pushes on the thinned spot, causing it to swell out like a balloon. The more the wall swells, the thinner it becomes. Over time, the wall of the artery may become thinner and may burst, causing a hemorrhagic stroke.

Hemorrhagic strokes are less common than ischemic strokes and symptoms are usually sudden and intense.

Stroke treatment

During a stroke, quick action is important! Our experienced team understands that a fast diagnosis gives patients a better chance for a full recovery. And when patients seek treatment immediately, doctors have more options to use the best technology available.

What happens at the emergency room?
At the emergency room you will receive a general physical and neurological examination. Your doctor will order a CT scan of your head soon after you arrive, to find out if you're having a stroke and the type of stroke. This will help determine the treatment that is best for your condition. Stroke treatment is determined by the kind of stroke, the severity of symptoms and your general health.

Treatment for ischemic stroke

"Clot-busting" drug - Intravenous (IV)
Ischemic strokes can be treated with a clot-busting drug known as tPA ( tissue plasminogen activator ). The drug helps to dissolve the blood clot. When given through an IV (usually in the arm), the medication travels through the bloodstream to the blockage. It must be administered within three hours of the onset of stroke symptoms.

"Clot-busting" drug - Intra-arterial
This method delivers clot-busting tPA directly to the blockage. During the procedure, the interventional neuroradiologist inserts a thin, flexible catheter into an artery (usually in the groin area) and guides it up to the clot in the brain. The tPA is then administered through the catheter. While this method can expand the treatment time window to six hours, it is more invasive than the IV procedure.

Clot retriever device
For patients who are ineligible for a "clot-busting" drug, St. Joseph's hospital offers a clot retrieval device that "grabs" clots and restores blood flow to the brain. The clot retriever is the first medical device to be cleared by the U.S. Food and Drug Administration (FDA) for patients experiencing an ischemic stroke.

The clot retriever is inserted into an artery in the groin and carefully led up to the brain. When it reaches the brain, it restores blood flow by capturing and removing the clot.

Treatment for hemorrhagic stroke

Treatments for hemorrhagic strokes include clipping and coiling to stop bleeding in the brain.

Clipping
During this surgery, a neurosurgeon opens the skull and separates the aneurysm from surrounding tissue. A small titanium clip will then be placed around the base of the aneurysm so that blood can no longer flow into it. The surgeon then drains the remaining blood out of the aneurysm and the empty aneurysm sac will shrink with time. When clipped correctly, the aneurysm should not return.

Coiling
Coiling is a newer, less invasive form of surgery. Unlike clipping, it does not require a craniotomy (opening of the skull). During the procedure, the interventional neuroradiologist inserts a catheter into the groin area and guides it up into the brain. The doctor then performs an angiogram to view the blood flow in the blood vessels in the brain. A fine wire is threaded into the catheter and carefully guided into the aneurysm. In the aneurysm, the wire twists into small coils. The doctor continues until the aneurysm is full of the tiny coils, causing the aneurysm sac to clot.

After a coiling procedure, follow-up angiograms are required at six months, two years and possibly five years.

Rehabilitation after stroke

After a stroke, it is important to build strength and confidence so you can continue your daily activities. Your doctor will work with rehabilitation specialists to provide a treatment program specifically suited to you.

Rehabilitation (rehab) begins in the hospital soon after a stroke. For some, it continues at home. Others require more intense rehab, for instance at Bethesda Hospital, or sub-acute (nursing home) care.

What you do in stroke rehab depends on your individual needs. The rehab specialists - including physical, occupational and speech therapists - can assist you with many skills including:

• Self-care such as feeding, grooming, bathing and dressing
• Mobility such as transferring or walking
• Communication in speech or language
• Cognitive skills such as memory or problem solving
• Socialization skills including interacting with other people