The right treatment at the right time
Centura Health offers numerous stroke treatment options aimed at limiting and possibly reversing stroke injury and preventing recurrent stroke.
For many years, stroke was the third leading cause of death in the U.S. Now, thanks to advances in technology and treatment options — like those at Centura Health — it’s fifth. Our stroke treatment includes the latest imaging software and minimally invasive emergency interventional techniques. Innovative technology paired with a multidisciplinary staff of neurologists, neurosurgeons and emergency room staff means you’ll receive faster, evidence-based care that’s been shown to improve outcomes. And with our stroke team available 24 hours a day, seven days a week, you can rest assured that we’re here when you need us most.
Centura delivers the right treatment at the right time, which can often mean the difference between life and death when it comes to a stroke. In recent years, care for stroke, especially the most common type of stroke, ischemic stroke (caused by a blocked artery), has evolved from supportive care to interventional treatments. In Centura’s Stroke and Neurovascular Program, neurointerventional specialists use minimally invasive techniques to treat brain aneurysms, open blocked arteries in the brain and remove clots in brain arteries.
Because seconds count when it comes to stroke treatment, our expert team of neurosurgeons and neurointerventionists specializes in emergency care of ischemic (caused by reduced blood flow to brain) and hemorrhagic (caused by bleeding in or near the brain) strokes.
We offer numerous stroke treatment options aimed at limiting and possibly reversing stroke injury and preventing recurrent stroke:
iSchemaView RAPID Technology
RAPID advanced imaging software quickly analyzes CT and MRI scans of those having acute strokes in real time, allowing doctors to rapidly assess the severity of the stroke and determine the most appropriate treatment, potentially saving brain tissue. The RAPID technology also gives our stroke team the ability to share these images that clearly illustrate the part of the brain that’s been damaged and parts that are at risk, which helps you or your loved ones better understand the treatment options.
Intravenous (IV) Medication Treatment with IV Alteplase (tPA)
Alteplase, or tPA, is a medication that can be used to treat some patients who have an acute ischemic stroke. Alteplase is often called a “clot-buster” because it helps to break up the blood clot and improve blood flow to the brain. Since it is a blood thinner, alteplase is not used for bleeding type strokes. Many people don’t arrive to the hospital in time to receive alteplase, which can save lives and reduce long-term effects of stroke. So, it’s important to identify stroke and seek treatment immediately.
The traditional time window for treatment with alteplase is 4.5 hours from the last time a person was seen well or without symptoms. There is new evidence to support the use of alteplase in a small number of patients who present with an unknown time of onset or who wake up with stroke symptoms. Beyond the 4.5-hour window, advanced stroke imaging is used to identify patients who may benefit from alteplase.
Some ischemic strokes can be treated directly inside the blocked vessel using minimally invasive small catheters (called microcatheters). A specially trained physician called a Neurointerventionalist can access an artery in the groin and thread the microcatheter up to the blocked vessel in the brain. Once at the affected artery, the neurointerventionalist can inject a clot busting medication (tPA) to restore blood flow. The neurointerventionalist may also remove the blockage completely using a device or suction. This procedure restores blood flow to the brain and is also known as mechanical thrombectomy or endovascular therapy. There is a time window for endovascular treatment where it is safe and effective to perform clot removal, which may be up to 24 hours from the patient’s last known well/normal.
Hemorrhagic Stroke Treatment
Emergency treatment for bleeding in the brain aims to stop the bleeding and control pressure inside the brain that can damage brain cells. If the area of bleeding is large, a neurosurgeon may perform a procedure to remove the blood clot and/or a portion of the skull to relieve pressure. Neurosurgeons may also place drains to remove excess fluid that causes pressure in the brain to rise to unsafe levels. If the bleeding is caused by the rupture of an aneurysm (a bulging/ballooning and weak area of a blood vessel), a neurosurgeon may place a tiny clip at the base of the aneurysm to stop blood flow to it and prevent further bleeding.
Neurointerventionalist may treat hemorrhagic strokes caused by aneurysms with coils. This procedure is also called endovascular embolization. In this procedure, a small catheter inserted into an artery in your groin and threaded to the aneurysm in the brain. The interventionalist will place tiny coils into the aneurysm to fill it. This blocks blood flow into the aneurysm and prevents further bleeding.
Preventing recurrent stroke
Your treatment doesn’t end when you leave our hospital. Here’s why: A person who has suffered a stroke has a much higher risk of having another one, compared to a person who has never had a stroke. After you receive treatment for stroke, our stroke team assesses your risk and takes steps to help you prevent another stroke. Neurological evaluations are performed frequently to monitor any change in your condition as soon as possible. For those who have spasm of blood vessels in the brain due to brain hemorrhage, specialized ultrasound monitoring is performed to guide therapy.
Stroke patients may receive the following:
- Anticoagulation therapy — For patients with atrial fibrillation (abnormal heart beat), blood does not pump completely out of the smaller, upper chambers of the heart and may pool and clot. If a piece of a blood clot leaves the heart and becomes lodged in a brain artery, a stroke results. Anticoagulation therapy involves prescribing blood-thinning medication that helps to prevent the formation of blood clots in the heart.
- Stroke education — Educational materials and support for patients and care providers
- Smoking cessation counseling — Smoking is a serious risk factor for a stroke. Before discharge, stroke patients who smoke receive counseling and information on ways to quit smoking.
- Antithrombotic medication — Within 48 hours of hospitalization, patients recovering from a mild stroke or who have had a recent transient ischemic attack (“ministroke”) are at high risk of having another stroke. Antithrombotic drugs, which prevent the formation of blood clots in arteries, are given with 48 hours of symptom onset in acute ischemic stroke patients who meet certain guidelines for these drugs.
See more information for managing your stroke risk factors on Stroke Risk & Prevention.