Stroke Testing and Treatment
Just as time is muscle when it comes to heart attacks, time is brain when treating stroke. Treatment depends on the type of stroke, the length of time elapsed since the stroke's onset and the stroke's location.
A "Door to CT time" of 45 minutes is one of HonorHealth's standards for stroke care. It's a measurement of the time that passes between each stroke patient's arrival in the emergency room and the moment a stroke team member interprets a diagnostic CT scan — the key instrument for determining the type of stroke.
Once you arrive in our emergency rooms for stroke treatment, you're immediately examined to determine the type, location and severity of the stroke. Faster diagnosis helps your team provide the necessary treatment, such as blood clot-bursting tPA medication for ischemic strokes, and help limit damage to the brain.
Primary Stroke Centers
At HonorHealth, emergency stroke care involves a skilled, highly coordinated team of neurologists, neurosurgeons, radiologists, nurses, rehabilitation physicians and therapists. Together, using the latest diagnostic and surgical techniques including robots to help a highly trained neurologist diagnose stroke patients remotely at a sister facility, they can identify and reverse damage to the brain caused by stroke.
HonorHealth's Primary Stroke Centers are equipped to provide consultation and evaluation of cerebrovascular-related issues, which include:
- Ischemic strokes.
- Hemorrhagic strokes.
- Transient ischemic attacks.
- AVM (Arteriovenous malformation).
Testing for Stroke
HonorHealth's doctor will perform a complete physical and neurological exam and will:
- Check for problems with vision, movement, sensation, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or is improving.
- Listen for an abnormal sound, called a "bruit," when using a stethoscope to listen to the carotid arteries in the neck. A bruit is caused by turbulent blood flow.
- Check and assess your blood pressure, which may be high.
HonorHealth may also use the following tests and diagnostic tools to help determine the type, location and cause of the stroke and rule out other disorders that may be responsible for the symptoms.
- 16-slice CT scanner technology: A high-powered X-ray machine that produces "cross-section" images. This CT scan of the brain is often done soon after symptoms of a stroke begin.
- MRI: Determines cellular changes in the brain.
- Electrocardiography: A tool that checks for irregular heartbeat — such as atrial fibrillation, a risk factor for stroke — and can tell if the heart is experiencing ischemia (lack of oxygen in the blood). Quite often, a heart attack and stroke can happen at the same time.
- Magnetic resonance angiography or CT angiography: May be done to check for abnormal blood vessels in the brain that may have caused the stroke.
- Echocardiogram: May be done if the stroke could have been caused by a blood clot from the heart.
- Carotid duplex (a type of ultrasound exam): Can show if narrowing of the neck arteries (carotid stenosis) led to the stroke.
- Angiogram: An angiogram of the head can reveal which blood vessel is blocked or bleeding, and help your doctor decide if the artery can be reopened using a thin tube.
- Laboratory tests: Will include a complete blood count (CBC), bleeding time and blood clotting tests (prothrombin time or partial thromboplastin time).
- Spinal tap: May also may be done.
Treatment for stroke depends on the type of stroke you're suffering:
- For ischemic stroke, the treatment goal is to remove blood vessel blockages and restore full blood flow to the brain as quickly as possible. If a you arrive within a few hours of first experiencing stroke symptoms, you can receive a drug called tPA, or tissue plasminogen activator. Administered by IV drip, tPA dissolves blood clots and reduces the severity of damage to the brain. Other blood thinning medications may be used.
- Treatment for hemorrhagic stroke depends upon the source and severity of bleeding. Medications are typically given to lower blood pressure and reduce swelling around brain tissue. If you've been taking blood-thinning medications, they are discontinued immediately.
- With an aneurysm, when a blood vessel ruptures, a procedure called aneurysm clipping involves placing a clip on the aneurysm to prevent further leaking of blood from the artery. Endovascular surgery involves threading a catheter and pushing delicate wires into the aneurysm site; the wires create a coil, around which a blood clot forms, sealing the blood vessel.
- Blockages in the carotid artery of the neck can be removed with carotid endarterectomy. Blockages within blood vessels of the brain can be removed by balloon angioplasty. A balloon-tipped catheter is maneuvered into the obstructed area of the artery. The balloon inflates, opening the artery and pushing plaque against the artery walls. This may be followed by inserting a wire mesh tube, called a stent, to keep the artery open.
HonorHealth has three certified Primary Stroke Centers in the Valley. For more information, contact the Primary Stroke Center nearest you:
Scottsdale Osborn Medical Center
7400 E. Osborn Road
Scottsdale, AZ 85251
John C. Lincoln Medical Center
250 E. Dunlap Ave.
Phoenix, AZ 85020
Deer Valley Medical Center
19829 N. 27th Ave.
Phoenix, AZ 85027