Stroke Screening, Diagnosis and Treatment
Screening and Diagnosis
Assessing your risk level is an important step that you can take to prevent a stroke. The St. Joseph Hospital Heart and Vascular Center offers a comprehensive screening program to help you obtain this critical information. Screenings include a medical history, physical examination and blood tests to check for high cholesterol or other conditions that may contribute to atherosclerosis. An ultrasound examination of your carotid arteries, the blood vessels in your neck that are the primary blood supply to the brain, will also be performed to determine if there is significant disease (e.g., atherosclerosis). An ultrasound is a non-invasive examination that uses ultrasound waves, instead of X-rays, to visualize the neck and other peripheral arteries.
The most important new development for treatment of ischemic stroke (caused by narrowing of a blood vessel or blood clot) is thrombolytic drugs (so-called “clot-busters”). These drugs allow for the blood clot to be dissolved in the cerebral arteries and allow flow to the portion of the brain that is being deprived of oxygen rich blood. Intravenous thrombolytic drugs may be given in the Emergency Room as a first line treatment for stroke patients, after confirmation by a CT scan and if a patient does not have any contraindications to the treatment. In addition or alone, thrombolytic drugs can be given directly into the cerebral artery that is blocked. This procedure is performed in the Interventional Radiology department, following a cerebral angiogram dye study. Immediate improvement in the symptoms of a stroke can be seen after the thrombolytic medication is administered into the artery and lower doses of the medication reduce the risk of intracranial bleeding.
The Interventional Radiology department uses two new techniques that remove blood clots mechanically:
- Merci Retrieval System. This is a catheter system that looks like a tiny corkscrew. The Merci Retrieval System is guided by the Interventional Radiologist directly into the cerebral blood clot, then is pulled back to remove the clot. The goal of treatment is to have intervention within two to six hours of witnessed onset of symptoms.
- Penumbra System. The Penumbra System is a package of tools used to remove clots from the large vessels of the brain that are causing a stroke. It works on the proximal surface of the clot, optimizing safety and eliminating the need for navigation beyond the clot. The Penumbra System allows clots to be gently aspirated out of intracranial vessels.