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 Regional Stroke Center has been awarded certification as a Comprehensive Stroke Center by the Healthcare Facilities Accreditation Program (HFAP), a national independent accreditation organization recognized by the Centers for Medicare and Medicaid Services (CMS). Certification confirms that St. Mary’s is providing high quality care as determined by an independent, external process of evaluation. 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.
Hospitals designated as comprehensive stroke centers have the capabilities and expertise to treat even the most complex stroke patients, and they can do it 24 hours a day, seven days a week.
The Comprehensive 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 including neurologists, neurosurgeons, interventional radiologists, emergency physicians, intensivists, hospitalists and advanced practitioners.
- 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 4.5 hours of onset of stroke symptoms.
Endovascular 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. St. Mary’s offers minimally invasive procedures for stroke, aneurysm, intracranial bleeding and blockages. Interventional radiologists are an important part of St. Mary’s Stroke Center. Physicians are available 24 hours a day, seven days a week.
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 Thrombectomy: A device is navigated into the brain's arteries 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. Special suction tubes may also be used to remove the 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. Fine 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, 128-slice and 256 slice CT scanners
- CT with angiography and perfusion
- MRI 1.5 and MRI 1.5 wide bore
- Bi-plane angiography suite
- Angiography for diagnosis of aneurysms, arterio-venous malformations and vascular occlusive disease
- Artificial intelligence software is used to synchronize stroke care, reducing delays that stand between patients and life-saving treatments. This is an innovative way of using technology to transform stroke workflow and patient care. The stroke team can consult with each other in real time through a HIPAA-compliant mobile interface, driving fast treatment decisions that save brain and save lives.
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. 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 designated stroke units. 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.
St. Mary's offers outpatient physical therapy in four convenient locations across our region. Post-stroke rehabilitation often involves multiple caregivers, including physical therapists, occupational therapists and speech/language pathologists, all of which are available in one location, 2841 Fifth Avenue, Huntington.
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.
BE FAST and call 911 if you see these signs of a stroke:
- BALANCE: Was there a sudden loss of balance?
- EYES: Did the person experience sudden loss of vision?
- 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.
A group of professionals at St. Mary's Regional Stroke Center is available to provide free stroke risk assessments at community health fairs or to provide informational presentations at community events. To request stroke screenings or a stroke awareness presentation at your organization, call 304.526.1281.
For more information about the Stroke Center, call 304.526.1281.