Today is World Stroke Day. It is a day dedicated to increasing awareness about stroke and the warning signs of stroke. Stroke strikes anywhere, anytime, across age, ethnicity, and socio-economic groups. I have never known anyone who planned on having a stroke.
Stroke is the result of disrupted blood flow to the brain. The more technical term is Cerebral Vascular Accident (CVA): cerebral = brain, vascular = blood flow, accident = unexpected. The more attention-catching media term is Brain Attack – much like a Heart Attack. A heart attack occurs when blood flow to the heart is interrupted and the cells that are electrical in nature stop functioning. Likewise, a brain attack occurs when the blood flow to the brain is interrupted causing the cells that are electrical in nature to stop communicating. The symptoms of the brain attack (stroke) will depend on which pathway for blood flow is interrupted and thus the corresponding region of cells whose communication is compromised.
I graduated with my bachelors’ degree in Physical Therapy in 1985. At that time, there was not a lot that could be done in regards to the emergency treatment of stroke. By the time I earned my doctoral degree in Neuroscience and Physiology in 1995 progress was in the making. In February 1996, a clot-busting medication was approved, by the Federal Drug Administration, for the emergency treatment of stroke.
Advances in imaging and drug delivery have helped to lengthen the treatment window for using tPA. Clot-retrieval devices that mechanically reach into a blood vessel to remove the clot have recently come onto the treatment scene and have lengthened the treatment time window. Surgical advances have also been made in the treatment of hemorrhagic stroke.
In 2003, the Joint Commission, a nonprofit organization that accredits and certifies healthcare organizations, joined forces with the American Heart Association and American Stroke Association (AHA/ASA) to begin certification of Primary Stroke Centers (http://www.strokeassociation.org). These centers are certified to provide for emergency treatment of stroke. More than 900 hospitals nationwide have been certified. It may be worth knowing which hospitals in your area are certified.
In 2012 this accreditation process was expanded and the Joint Commission together with AHA/ASA began certification of comprehensive stroke centers. These centers are even more specialized having advanced treatment and surgical tools for the emergency management of stroke.
With more awareness, better treatment and improved follow-up rehabilitation, we can reduce the devastation caused by stroke.