July Health Matters 2019

Knowing the Symptoms of Stroke and when to call for help could save a life

When a person suffers a stroke, it is because the brain is not getting the blood it needs to function properly. A stroke can be attributed to a rupture in a blood vessel, or more likely to a build-up of plaque in the arteries or a clot that has broken free, restricting the free flow of blood to the brain.

Dr. R. Viktoria Totoraitis and Brenda Hartmann, NCH System Stroke Coordinator.

It is important to know the main signs of stroke so that you will be prepared to act quickly if it happens to you or someone you love. Do the FAST test:

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F ACE Ask the person to smile. Does one side of the face droop?

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S PEECH Ask the person to repeat a simple phrase. Is there slurring or difficulty?

T IME If you answer any of these questions, you must act quickly.

Ask the person to raise their arms.

Is there difficulty on one side? Any numbness or weakness?

NCH SHINES AS A STELLAR STROKE CARE PROVIDER: • NCH is a Joint Commission designated Primary Stroke Center • NCH is designated as a Comprehensive Stroke Center through the Agency for Health Care Administration (ACHA) • NCH received the American Heart Association (AHA) "Get with The Guidelines - Stroke Gold Plus Achievement Award with Target: Stroke Honor Roll Elite Plus” for 2016, 2017, 2018, 2019.

“Do not waste time calling a doctor or driving to the hospital. Call 911 immediately to get emergency medical services (EMS) rolling to you as soon as possible,” says R. Viktoria Totoraitis MD, Vascular Neurologist Specialist and NCH Medical Stroke Director. “Depending on the location of the stroke, the patient may exhibit symptoms usually on one side of the body, such as face droopiness, arm weakness, numbness, sudden vision loss or double vision,” explains Dr. Totoraitis. “The patient may also have an inability or difficulty speaking, intense dizziness and sudden changes in balance, coordination or their ability to walk.” Strokes are classified either as ischemic – which is caused by a disruption of blood flow to the brain due to plaque build-up in the arteries or a blood clot – or hemorrhagic – which is caused by a ruptured blood vessel. Ninety percent of all strokes are classified as ischemic. A person’s risk for stroke increases with conditions such as atherosclerosis, or a build-up of plaque in the arteries, other arterial and vascular diseases, and heart disease explains Dr. Totoraitis. Potential cardiac causes of stroke include arrhythmia, or an abnormal heart beat rhythm, and heart failure, where the heart is unable to pump a volume of blood sufficient for meeting the needs of the body. “Many times, there is no clear, underlying cause for cardiac-related or rhythm related strokes,” says Dr. Totoraitis. “But we do see it more often with heavy alcohol use, age, and wear and tear on the heart.” Two potential acute stroke treatments include TPA (tissue plasminogen activator), a clot-busting medication that helps dissolve clots that could be blocking blood flow, or an embolectomy, which is performed by an interventional radiology specialist who can manually remove the clot. “After we determine the acute care plan, we admit the patient and do additional work up studies like echocardiograms and heart monitoring,” explains Dr. Totoraitis. “We also address their risk factors and prescribe the right medication. Afterwards, a therapy-based stroke rehabilitation plan is developed with physical, speech and occupational therapists depending on the patient’s needs and whether they will require an in- or out-patient setting.” Once a patient arrives at the hospital’s emergency department, imaging studies are performed to look at blood vessels and the brain to determine if the patient is a candidate for acute procedures.

Call 911 for help when these stroke-warning signs appear

• Face droopiness • Armweakness • Numbness • Difficulty or inability to speak • Sudden vision loss • Sudden double vision

Prevention, she says, includes “good, old–fashioned, healthy living,” and regular doctor visits to detect hidden high blood pressure.

Brenda Hartmann, MSN, SCRN, NCH System Stroke Coordinator, says that NCH received the American Heart Association (AHA)’s "Get With The Guidelines ® and Target: Stroke Quality Achievement Award.”

Prevent Stroke by Controlling Risk Factors

“This designation indicates that the time from arrival into the ER to the time the initial medication is administered is under 45 minutes,” states Hartmann. “At NCH, we average about 30 minutes.”

• Monitor blood pressure • Keep cholesterol in check • Maintain a healthy diet to avoid diabetes • Exercise • Quit smoking • Limit alcohol use • Stop smoking

For more information about the NCH Stroke Program , call Brenda Hartmann at (239) 624-4172

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