Having a stroke while on vacation is not anyone’s idea of a good time. But for a 48-year-old central California woman, it was a lifesaver. Last fall, she collapsed while visiting family In Orange County.
Comatose, she was rushed to UC Irvine Medical Center where the experts at the Comprehensive Stroke & Cerebrovascular Center diagnosed her with a subarachnoid hemorrhage. This occurs when an abnormal bulging blood vessel in the brain — an aneurysm — has burst, causing bleeding in the space between the brain and the tissue covering the brain. Permanent brain damage or death may result if not treated quickly.
Quick response to aneurysm is crucial
“When an aneurysm ruptures, survival and recovery depend on a quick response from an experienced team of specialists,” says neurosurgeon Dr. Li-Mei Lin.
“We were the first comprehensive stroke center in Orange County, offering state-of-the art facilities and a team of neurologists, neurosurgeons, neuro-intensive care specialists and nurses who have earned advanced stroke care certification. Our highly skilled team is trained to receive and treat patients with the most complex strokes.”
Lin immediately treated the aneurysm through a minimally invasive procedure called endovascular coiling. Rather than making an incision in the skull, the physician passes a catheter through the femoral artery in groin up into the artery containing the aneurysm. Metal or platinum thread-size coils are then packed into the aneurysm to prevent blood from flowing into it.
Thanks to the advanced care she received, the patient walked out of UC Irvine Medical Center two months later and was able to return to her job as an attorney within six months.
Why a comprehensive stroke center?
Stroke is the No. 1 cause of disability and the No. 5 leading cause of death in the U.S.
The “comprehensive” reference is not just a marketing slogan. Before a hospital can call itself a comprehensive stroke center, The Joint Commission, the nation’s leading healthcare accrediting agency, must certify that the hospital has the specialized care, expert staffing and advanced technology necessary to deliver the highest level of stroke care.
More than 100 certified comprehensive stroke centers in the U.S. follow guidelines developed by the American Heart Association and American Stroke Association. Comprehensive stroke center certification means a hospital is ready 24/7 to deliver advanced stroke care. It’s the highest level of stroke certification, earned by meeting standards for the most complex stroke cases.
Questions to ask about stroke care
When emergency medical personnel arrive, tell them you want the your loved one taken to a comprehensive stroke center. If there is not one in the area, they will be taken to the nearest community hospital for treatment.
Many community hospitals are not equipped to offer the specialized care and advanced technology found at a comprehensive stroke center. You may want to request a transfer to the nearest comprehensive stroke center after your loved one is stabilized.
While the patient is being stabilized at the community hospital, ask the following questions about stroke care:
- If the hospital is not a certified primary stroke center, does it participate in a telemedicine program with a comprehensive stroke center?
- What kind of stroke did my loved one have — ischemic or hemorrhagic?
For an ischemic stroke:
- Can the hospital administer the clot-busting drug tPA?
- Can the hospital remove the clot through an endovascular procedure?
- Will my loved one be administered tPA and then transferred to a comprehensive stroke center?
For a hemorrhagic stroke:
- Does the hospital perform a procedure called vetriculostomy to drain any fluid buildup on the brain?
- Does the hospital offer the surgical treatment called clipping to prevent further re-bleeding?
- Does the hospital offer the endovascular treatment called coiling to prevent further re-bleeding?
- Will my loved one be stabilized and then transferred to a comprehensive stroke center?
Most strokes, called ischemic, are caused by a clot that blocks blood flow to the brain. Less common is the hemorrhagic stroke, which is usually caused when a blood vessel in the brain bursts. Hemorrhages account for only 13 percent of strokes, but lead to 50 percent to 80 percent of stroke-related deaths.
What to do if you witness a stroke
Stroke symptoms vary, and can start slowly or come on quickly.
A stroke can happen when just one of these symptoms occurs:
- Numbness or weakness of the face, arm or leg, especially on one side of the body
- Confusion or trouble speaking or understanding
- Trouble seeing in one or both eyes
- Trouble walking, dizziness or loss of balance or coordination
- Severe headache
If your loved one experiences any of these symptoms for longer than a few minutes, immediately call 911. Don’t ignore the symptoms even if they go away before the emergency responders arrive, and do not refuse medical attention. Make note of the time when the symptoms started, an important piece of information to relay to the medical staff.