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The Hands of Experience® in Advanced Health Care

Stroke Center

During a stroke, every second counts. The physicians, surgeons and staff at St. Mary’s Regional Stroke Center are specially trained to diagnose and treat stroke patients quickly to minimize the amount of damage to the brain.

St. Mary’s was the first primary stroke center in the Tri-State certified by the Joint Commission. The center has also received the Get With the Guidelines® Stroke Gold Plus quality achievement award from the American Heart Association and American Stroke Association every year since 2011 for excellence in the treatment of stroke patients.

The Regional Stroke Center at St. Mary’s offers a broad range of services for patients with stroke and cerebrovascular disease, including:

  • Acute stroke treatment 24 hours a day, seven days a week, by a team of highly trained professionals
  • A dedicated neuroscience and stroke unit and critical care units staffed by a multidisciplinary team of registered nurses and therapists. The professionals are certified by the American Stroke Association in NIH Stroke Scale assessment and receive extensive stroke-related education annually.
  • Continuous quality improvement through the American Stroke Association’s “Get With the Guidelines” program
  • Endovascular stroke treatment, including intra-arterial thrombolysis, clot-retrieval devices, intracranial stents, cerebral aneurysm coils and carotid artery stents
  • Surgical treatment, including carotid endarterectomy and cerebral aneurysm clipping
  • Advanced diagnostic and imaging techniques
  • Early intervention by rehabilitation therapists and referral to the appropriate level of therapy at discharge

Treatments

Acute stroke treatment

Intravenous thrombolytic therapy: Thrombolytic agents, or clot busters, are used to treat an ongoing acute ischemic stroke caused by an artery blockage. These agents dissolve the blood clot that is blocking blood flow to the brain. Clot-busting medications can be administered intravenously to patients who meet strict criteria and arrive to the Emergency Department in time to allow the medication to be given within three hours of onset of stroke symptoms.

Interventional stroke treatment

Interventional radiologists have an ever-growing impact on the field of stroke, performing new endovascular procedures to prevent, diagnose and treat neurovascular diseases and disorders. At St. Mary’s, they offer minimally invasive procedures for stroke, aneurysm, intracranial bleeding and blockages. Interventional radiologists are an important part of St. Mary’s Stroke Center.

Intra-arterial thrombolysis: Interventional radiologists administer a small amount of a “clot-busting” drug directly into the artery at the site of the blood clot that is causing the stroke. A small catheter is inserted into the artery at the groin and threaded to an artery in the brain. This procedure is used to treat strokes caused by a blood clot that is blocking flow of blood through an artery in the brain.

Mechanical therapy: Mechanical therapies to remove blood clots and restore flow are a new approach to the treatment of ischemic stroke. A device is navigated into the brain using standard catheterization techniques. Upon reaching the targeted area in the brain, the clot retriever is designed to restore blood flow by engaging, capturing and removing the blood clot.

Intracranial angioplasty: Bleeding in the brain can cause spasms in blood vessels and block blood flow. In intracranial angioplasty, a neuro-interventional radiologist (an interventional radiologist with specialized training to perform brain procedures) inserts a catheter into the vessel and inflates a balloon to open the constricted area and restore blood flow. If there is a risk that the balloon might rupture an artery, the physician may administer medications through a catheter that help relax and reopen the artery without using a balloon.

Cerebral aneurysm treatment

A cerebral aneurysm is a weak area in the wall of an artery in the brain. The weakened wall often stretches and swells outward, forming a bubble-shaped area on one side of the vessel. Without treatment, the aneurysm can rupture and bleed.

Cerebral aneurysm coiling: A neuro-interventional radiologist inserts a catheter into the artery and threads it into the aneurysm. Platinum coils are inserted into the aneurysm to cause a blood clot to form, which seals off the aneurysm. Metal stents may be used to keep the coils in place.

Clipping: A neurosurgeon performs a craniotomy and locates the aneurysm in the brain. A tiny metal clip is placed across the neck of the aneurysm to stop blood flow into the aneurysm and prevent it from rupturing.

Diagnostics

St. Mary’s Medical Center provides many diagnostic services for patients with neurological disorders and injury.

Neurovascular Lab

The Neurovascular Lab uses transcranial doppler ultrasound and carotid duplex scans to assess the risk of stroke. Transcranial doppler ultrasound is a safe, non-invasive technology for measuring blood flow velocities (speed) in the brain. Carotid duplex scan is a non-invasive ultrasound to measure the flow of blood through the arteries of the neck to the brain.

Radiology

The radiology department at St. Mary’s offers the following services and advanced technology for the diagnosis and treatment of neurological illnesses and stroke:

  • 64-slice and 128-slice CT scanners
  • CT with angiography and perfusion
  • MRI
  • Bi-plane angiography suite
  • Angiography for diagnosis of aneurysms, arterio-venous malformations and vascular occlusive disease

Inpatient Neuroscience and Stroke Unit

St. Mary’s inpatient neuroscience and stroke unit has an experienced, caring team of doctors, nurses, therapists and social workers to help patients recover from neurological diseases and disorders. Many of the nurses on the neuroscience unit are certified neuroscience registered nurses (CNRNs) by the American Board of Neuroscience Nursing. These staff members specialize in their field and have extensive knowledge and experience in caring for neurological patients. The neuroscience team conducts frequent “care conferences” to set goals for each patient and evaluate their progress.

Care is provided through an interdisciplinary team approach on the neuroscience unit. Speech therapy, physical therapy and occupational therapy play an important role in the care of neurological patients. Physical therapists work with patients on skills, such as balance, that require the use of large muscles in the body. Occupational therapists focus on fine motor control skills, such as dressing, grooming and eating. Speech therapists can help neurological patients who have difficulty speaking and processing language. They also can help patients who have difficulty chewing and swallowing. Social workers, dietitians and case managers also play an important role in the neuroscience team.

Outpatient Rehabilitation

Therapists in the rehabilitation department at St. Mary’s offer individualized, comprehensive, hands-on outpatient physical, occupational, and speech therapy services to help patients achieve the highest level of function in all tasks.

St. Mary’s Rehabilitation Services offers the latest in physical therapy equipment, including the Neurocom Balance Manager, which is utilized to objectively measure balance and falls risk and allows the therapist to create a custom treatment plan for each patient. In addition to therapists who specialize in treating balance, gait and strength impairments, we also offer pelvic health therapy to treat urinary incontinence and speech therapy services to treat swallowing and speech impairments.

Above all, our mission in outpatient rehabilitation is to make patients feel like they are at home. We encourage the family to get involved in the patient’s care by assisting the patient in a home exercise program and being present for therapy sessions.

Prevention

Patients who have blockages of the carotid artery may be eligible for carotid endarterectomy surgery or carotid stent. These procedures keep blood flowing through the carotid artery, the main artery in the neck that supplies blood to the brain. Carotid artery stenting is a procedure used to help reduce the risk of stroke and has been shown to improve outcomes for neurovascular patients. It is used when the artery is narrowed because of a build-up of plaque that reduces blood flow to the brain. The procedure involves insertion of a thin mesh tube called a stent, which expands in the carotid artery to increase blood flow in areas blocked by plaque.

Community education

Do you know the signs of a stroke?

Knowing the symptoms of stroke, calling 911 and seeking treatment at a certified stroke center, such as St. Mary’s Medical Center, are the most important steps that may lead to a reduction in the disability caused by stroke. An important goal of the Stroke Center at St. Mary’s is to educate the public to know stroke symptoms, and to take steps to reduce the risk of the disease.

Act FAST and call 911 if you see these signs of a stroke:

FACE: Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
ARMS: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
SPEECH: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence.
TIME: If you notice any of these symptoms, even if they go away, call 911 and get the person to the hospital immediately. Check the time so you will know when the first symptoms appeared.

Health Screenings

St. Mary’s frequently offers free stroke risk assessments through the wellness program. A group of stroke professionals at St. Mary’s provides the assessment and educates community members about stroke prevention and recognition. To request a stroke awareness presentation at your organization, please call (304) 399-7444.

For more information about the Stroke Center, call (304) 526-1281.