Stroke center delivers lifesaving care

Swift treatment spares stroke patients from death, disability

December 01, 2012

Timing. It often determines whether a stroke victim will resume a normal life, suffer disabilities – or even survive.

“From the onset of symptoms until treatment begins, there are only four and half hours in which intravenous clot-busting drugs are effective,” says neurologist Dr. Steven Cramer of the UCI Health Comprehensive Stroke & Cerebrovascular Center at UC Irvine Medical Center. Other treatments, including leading-edge neurointerventional procedures, also must be initiated quickly in order to remove blockages in blood vessels and restore oxygen-carrying blood flow to the brain.

When administered in time, these treatments can reduce the incidence of stroke-related disability in up to half of all cases.

“We treat a stroke with the same urgency as a heart attack,” said neurologist Dr. Lama Al-Khoury, a member of the stroke team.

UC Irvine Medical Center was the first in the nation to be certified as a primary stroke center by The Joint Commission, signifying that it meets the highest standards for rapid, expert stroke care. Further, in an effort to speed up the care of stroke patients, Cramer led the effort to establish a system of stroke-neurology receiving centers in Orange County in 2009. “The network ensures that stroke patients are transported by EMTs and paramedics to hospitals equipped and staffed 24 hours a day to provide the most advanced treatment,” he said.

To qualify as a stroke-neurology receiving center, hospitals must have a dedicated medical director and round-the-clock emergency physicians, neurologists, neurosurgeons and interventional radiologists. They must also be equipped and staffed for MRI and CT testing at all times. The medical center in Orange was among the first of six hospitals designated by the Orange County Health Care Agency as a stroke-neurology receiving center.

After surviving a stroke, a patient’s care continues because of the heightened risk for having another stroke. However, this high repeat stroke risk can be reduced by up to 80 percent by proper medical management of risk factors, after the initial stroke. UCI Health neurologists routinely treat stroke survivors as outpatients to prevent additional strokes.

“Stroke is a lifetime disease,” says Dr. Shuichi Suzuki, a UCI Health interventional neurologist who performs treatments that reopen blocked brain arteries. “The stroke, the emergency, happens because the patient has a disease. Stroke is the end stage of that vascular disease. So we treat the stroke, and then we have to work on preventing another.”

The Stroke & Cerebrovascular Center also is aggressive in the treatment of transient ischemic attacks — known as TIAs — which are akin to short-lived “mini-strokes.” TIA symptoms are the same as those for a stroke but are often are shrugged off. While the symptoms quickly pass, TIAs are a red flag. After a TIA, there is a 5 percent chance of having a stroke within 48 hours and a 10 percent chance of one occurring within three months. With immediate care, that stroke can be prevented.

“It’s an emergency whether it’s a stroke or a TIA,” said Cramer. “You need to be evaluated immediately because time is critical. Every second matters.”

Stroke symptoms

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