Stroke

When you come to Premier Health for stroke services, you get advanced, critical care — from the emergency department through treatment and recovery. Our stroke teams use a comprehensive, patient-centered model designed to give you the healthiest outcome possible.

If you go to an emergency room in the Premier Health TeleStroke Network we help to ensure a rapid assessment and treatment to dissolve a clot or repair a damaged blood vessel and minimize brain damage.

Stroke services at Premier Health combine the experience of doctors, nurses, therapists, and other health providers from multiple specialties with technology and research.

Our multidisciplinary approach means we deliver care that goes beyond the emergency room and contributes to improving your quality of life long after the stroke event.

Highest Level Of Award-Winning Stroke Care

We are home to the Dayton area’s only Comprehensive Stroke Center, as awarded by The Joint Commission and the American Heart Association/American Stroke Association. This is the highest designation of advanced stroke care a hospital can receive.

Joint Commission-certified Comprehensive Stroke Centers are recognized as industry leaders and are responsible for setting the national agenda in highly specialized stroke care. Miami Valley Hospital is the first Joint Commission-certified Comprehensive Stroke Center in the greater Dayton region.

As a Comprehensive Stroke Center, Miami Valley Hospital must maintain multiple teams of physicians ready to care for patients at every stage of the stroke process. Miami Valley Hospital meets these rigorous requirements:

  • 24/7 availability of neurointerventional procedures and neurosurgery 
  • A dedicated neuro-intensive care unit for complex stroke patients that provides neuro-critical care 24 hours a day, seven days a week
  • Advanced imaging capabilities
  • Post-hospital care
  • Stroke research

The stroke program also relies heavily on the work of EMS personnel and emergency department physicians to serve as the first points of contact.

The Joint Commission and the American Heart Association/American Stroke Association recognize all Premier Health hospitals for excellence in patient stroke care and outcomes.

Our designations include:

  • Atrium Medical Center: Advanced Certification for Primary Stroke Centers
  • Upper Valley Medical Center: Advanced Certification for Primary Stroke Centers
  • Miami Valley Hospital North: Certified Acute Stroke Ready Hospital
  • Miami Valley Hospital South: Advanced Certification for Primary Stroke Centers

Our hospitals hold many other awards and recognitions for our achievements in stroke care.

Stroke Symptoms And Warning Signs

A stroke occurs when blood flow to part of the brain is blocked or stops. Brain cells begin to die within minutes. That’s why we say that with stroke, time is brain.

Stroke symptoms appear suddenly and are a sign of a medical emergency. If you think you or someone else is having a stroke, call 911 and get medical help right away.

Learn to recognize stroke symptoms and warnings signs. An easy way to remember what to look for is to think and BE FAST:

B — Balance: Does the person have a sudden loss of balance?
E — Eyes: Has the person lost vision in one or both eyes?
F — Face: Ask the person to smile. Does one side of the face droop?
A — Arm: Ask the person to raise both arms. Does one arm drift downward?
S — Speech: Ask the person to say something. Is the speech slurred or garbled?
T — Time: If you notice any of these symptoms, call 911 immediately. Time is critical!

Other sudden stroke symptoms may include:

  • Numbness, tingling or weakness in the face, arms or legs, especially on one side
  • Severe headache, with no apparent cause
  • Trouble speaking or understanding
  • Confusion

Types Of Stroke

There are two main kinds of stroke.

  • Ischemic stroke occurs when blood flow to the brain is blocked. A blood clot or the buildup of plaque inside an artery can narrow the passageway. If a piece of a clot or plaque breaks off, it will flow with the blood until it gets stuck in a small blood vessel in the brain. Ischemic stroke are the most common form of stroke. 
  • Hemorrhagic stroke occurs when a blood vessel in the brain bursts or leaks. When this happens, blood pools into nearby brain tissue and puts pressure on the brain, damaging cells. Other parts of the brain may also be damaged because their normal blood supply is cut off.

Some people get one or more mini strokes (TIA) before a damaging stroke.

  • TIA (transient ischemic attack) is considered a warning stroke. One third of people who have a TIA have a stroke within a year. The signs and symptoms of a TIA are similar to a stroke but do not cause lasting damage. TIA symptoms usually last less than an hour but can last up to 24 hours. TIAs usually occur when a blood clot or spasm in the artery temporarily blocks blood flow.

Stroke is the fifth leading cause of death in the U.S., according to the Centers for Disease Control and Prevention, and a leading cause of disability among adults. Your quick recognition of a stroke or TIA is the key to making sure you or another person gets immediate medical care that can prevent further damage.

Diagnostic Tests For Stroke

Your stroke team quickly performs tests to determine the type of stroke you are experiencing. This information lets your doctor find the right specialized treatment for you. Diagnostic tests used by your stroke team may include: 

Depending on your symptoms and imaging test results, your stroke team may perform additional tests to:

  • Locate a clot
  • Locate bleeding
  • Assess brain damage

Stroke Treatments

Immediate treatments for stroke are designed to restore blood flow to the brain. The treatment your stroke team will use depends on your specific type of stroke and the location of the blockage or damaged blood vessel. The sooner treatments begin, the better the result.

Once the emergency situation is resolved, your doctor will refocus your treatments on any needed rehabilitation and stroke prevention.

Ischemic stroke treatments include:

  • tPA (tissue plasminogen activator): This clot-busting drug prevents cell damage by breaking up a clot and restoring blood flow and oxygen delivery. The medicine is most effective when given as soon as possible after stroke symptoms begin. The tPA that stroke teams use is a man-made version of an enzyme made by cells in blood vessel walls.
  • Clot removal. Advances in stroke care mean that new procedures for removing clots (endovascular stroke rescue) from large blood vessels in the brain can restore blood flow and reduce the loss of function. Clot removal works best when performed within six hours of the start of stroke symptoms and can be successful with or without the use of tPA. Types of clot removal procedures include:
    • Intra-arterial catheter reperfusion uses a tool with a coiled tip to grasp a blood clot and remove it. This method can be used up to 12 hours after the start of stroke symptoms.
    • Solitaire™ revascularization threads a catheter through an artery in the groin and into the blocked artery in the brain. A tiny wire mesh tube (stent) opens in the blocked artery and restores blood flow. After several minutes, the clot sticks to the stent and is removed by the catheter. Solitaire revascularization can be used up to eight hours after stroke symptoms begin.
    • 5Max ACE™ removes clots causing a stroke by placing a thin tube-like device through an artery in the groin to the blocked brain artery. The 5Max ACE lets the doctor suction out the clot to clear the artery and re-establish blood flow quickly and with less tissue trauma.

Hemorrhagic stroke treatments include:

  • Coil embolization is a minimally invasive procedure. A neurointerventional specialist threads a catheter through an artery in the leg to the damaged blood vessel in the brain. Tiny coils are placed in the opening. The coils help a clot to form, filling the open space and preventing blood from entering surrounding brain tissue.
  • Onyx® embolization Onyx is a liquid glue that closes abnormal tangles of arteries and veins (AVMs or arteriovenous malformations that can cause bleeding or a burst aneurysm in the brain. Onyx is delivered by a microcatheter through an artery in the groin to the damaged area of the brain. Onyx hardens when it mixes with blood, stopping bleeding and plugging any holes in the blood vessels.
  • Aneurysm clipping surgically repairs blood vessel bulges that cannot be treated with coils. The neurosurgeon removes a small piece of the skull to access the brain and remove any trapped blood. A clip placed on the bulging blood vessel cuts off its blood supply and prevents bleeding.
  • Pipeline™ embolization uses a mesh tube to shift blood flow away from the damaged blood vessel to allow a clot to form.

Some patients with a hemorrhagic stroke may need additional treatments to relieve pressure and prevent further damage to brain tissue, such as:

  • Surgeries that can remove excess blood, reduce pressure on the brain or open blocked veins that move blood away from the brain
  • Calcium channel blocker medicines to prevent complications from lack of blood flow to the brain after a hemorrhagic stroke
  • Vasopressor medicine injections to prevent a stroke
  • Anti-seizure medicines to treat seizures related to a stroke
  • Vasodilator medicine to decrease pressure on the brain

If your stroke damaged brain tissue, your doctor may recommend rehabilitation to help restore function.

You may also qualify to participate in a clinical trial to test new stroke treatments or to use an experimental medicine. Talk with your doctor whether or not a clinical trial is right for you.

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