If someone suffers a stroke one of the most important things that we do as a stroke team is identify why they had that stroke. It's been easier, because of imaging of late, to know definitively the person’s had a stroke on MRI. It identifies it very quickly, very easily. But that's only 10% of the picture I would argue. I mean yes now we can identify you had a stroke, but we need to figure out why you had it and how to prevent it in the future. Which is much more important to the overall health of this individual. And that's a tough question to answer. What we do on our stroke service is we run a series of tests while the patient’s in the hospital. Usually over a day or two. We work through the various possibilities that could have caused the stroke, which include looking at the arteries in their neck and their head to make sure that there's not plaque. The same plaque we talk about in people in people's hearts and other arteries in their body can form in the arteries in the neck and in the head and block arteries, causing stroke. We look for arteries that might be damaged from trauma or other things with these same images. We also, of course, use MRI to look at the brain tissue, to make sure they don't have underlying genetic disorders that might lead to further strokes that we could potentially ward off. We look at their heart with specific tests that again identify risks that could cause stroke coming from the heart. And after doing all of this we then check labs that look for their cholesterol counts to assure that their cholesterol count is well-controlled. Of course, throughout the whole stay we monitor their blood pressure. Again if they are found to have high blood pressure, we start medications that would work to lower that pressure as they exit out of the hospital and hopefully go home or to rehab. We look at various factors about smoking and stopping smoking and having people counsel them. And if they are diabetic we have diabetic counselors and of course specialists to come in and talk about good eating habits, exercise and those types of things that could control your blood sugars if you are a diabetic patient. All of those things happen in the hospital but it doesn't just stop there. The continuity of care is very important for stroke patients to continue those trends throughout their whole lives. So we start medications to prevent stroke and then we follow them up in clinic, usually shortly thereafter. And there's a very set and strict guideline that we use to assure that no one falls through the cracks and that they receive their medications and screening tests that they need to continue to try to protect them in the future from having another stroke.
