A Stroke Can Happen At Any Time

Just Ask Diane

It was pretty much an ordinary day for Diane Snyder: a busy work day, kitchen chores, and some time relaxing on the couch with her son’s girlfriend. The rest of her family was scattered throughout the house.

She tried to lift a water bottle from the floor and couldn’t grasp it, and the left side of her face suddenly went slack. Fortunately, Diane’s family members recognized the significance of her symptoms and called 911.

Diane was experiencing a stroke.

Even more fortunately, she was whisked to the Stroke Center at St. Luke’s University Hospital - Bethlehem.

In 2017, St. Luke's was recognized with the American Stroke Association's Get With The Guidlines® - Stroke Gold Plus, Target: Stroke Honor Roll Elite Award. This award recognizes St. Luke's commitment to providing the most appropriate stroke treatment according to nationally-recognized, research-based guidelines.

“That’s the highest award a hospital can receive from the Association,” says Daniel Ackerman, MD, Medical Director of the St. Luke’s Stroke Center. “St. Luke’s is one of only 17 hospitals in Pennsylvania to be so honored, and the only one in this area.”

One critical aspect of stroke care is the speed of response. “In one evaluation, it was found that a typical patient will lose two million brain neurons for every minute that stroke goes untreated. And if an hour goes by, the brain will ‘age’ about 3-1/2 years,” Dr. Ackerman adds.

Currently, St. Luke’s boasts an impressive average pickup-to-hospital time of just 5-1/2 minutes within the city of Bethlehem.

“I was taken to St. Luke’s by the Upper Bucks County Regional EMS.

Their response time was phenomenal. I learned later that the crew arrived about three minutes after the call came in,” Diane says.

But raw speed is just half of the equation. The other is the presence of a coordinated team of professionals at the hospital. And, at St. Luke’s that team is in place before the patient comes through the doors.

“When the EMS team recognizes a stroke, they call the hospital immediately. Everyone there knows a stroke patient is in transit, and we begin a fast-track process,” says Martin Oselkin, MD, neuro-interventionalist. Admissions paperwork begins, additional blood tests are ordered, and diagnostic hardware is activated. At the same time, neurologists, nurses, anesthesiologists, surgeons, technologists, even the transport crew assembles and is ready to go.

The majority of strokes are of the ischemic type: a clot prevents the flow of oxygenated blood to the brain. “One of our first tests during patient evaluation is a computed tomography angiogram,” says Evan Marlin, MD, endovascular neurosurgeon. It’s a technique that is used to visualize arterial and venous vessels throughout the body.

Relatively small clots are often treated with tissue plasmogen activator (“tPA”), a protein that’s often referred to as a “clot buster.”

And if the clot is larger—or if tPA doesn’t work—surgical intervention is the next step.

“In the interventional suite, we rely on the CT angiogram for guidance; commonly, one of our surgeons will insert a small tube, or catheter, into the femoral [thigh] artery and run it up to the clot,” Dr. Marlin says. “Another catheter, inserted past the clot, enables us to use a multitude of tools to remove it.”

“A CT scan showed that my clot was at the base of my skull on the right-hand side. Although I was a candidate for tPA treatment, I still needed surgical intervention to remove the clot. After it came out, blood flow to my brain went back to normal,” Diane says.

Although every surgery has some risks, the risk involved in doing nothing is greater. “Based on several studies, rates of mortality and recovery of function are significantly improved by these procedures,” Dr. Marlin says. But if left untreated, “the affected portion of the brain essentially dies, resulting in an irreversible condition,” he adds.

The Stroke Center at St. Luke’s—with its combination of speed, technology, dedication, and expertise—certainly came through for Diane Snyder. “My stroke came out of nowhere,” she said. “I had none of the usual risk factors—diabetes, high cholesterol, or hormone replacement therapy for example—but it still happened. After the clot came out, everything went back to normal for me. I didn’t need speech therapy, physical therapy, or anything else. I still have trouble wrapping my head around the fact that I basically just walked away from a stroke. I’ll always be grateful for the tremendous care I received at St. Luke’s.”

When you suspect a stroke, B-E   F-A-S-T!

Simply put, a stroke is a blockage of blood flow to the brain. It’s a common occurrence—about 800,000 cases per year, or one every 40 seconds. “Stroke is all about location,” Dr. Ackerman says. “You could have a major stroke in some parts of your brain and feel only minimal effects. But a tiny stroke in a crucial area of your brain can change your life forever.”

How can you tell if someone is experiencing a stroke? Given that a quick response is so important, it’s fitting that six major signs of stroke can boil down to “BE FAST.” If you observe any of them, call 9-1-1 right away.

Balance. Is the person experiencing a sudden loss of balance?

Eyes. Does the person have a sudden loss of vision in one or both eyes?

Face. Ask the person to smile. Does his or her face look uneven?

Arm. Ask the person to raise both arms. Does one arm drift down?

Speech. Ask the person to repeat a simple phrase like “the sky is blue.” Does his or her speech sound strange?

Time. If you observe any of these signs, note the time the symptoms started and call 911 or an ambulance.

Daniel Ackerman, MD
Stroke Center Medical Director
St. Luke’s University Health Network

Evan Marlin, MD
Endovascular Neurosurgeon
St. Luke’s University Health Network

Martin Oselkin, MD
St. Luke’s University Health Network

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