The Delta Primary Stroke Center at Greenwood Leflore Hospital: GLH partnership with St. Dominic’s
Each year, almost 800,000 Americans suffer from strokes; 130,000 of these patients will die, making stroke one of the nation’s top fatal diseases. Because strokes affect the blood supply to the brain, they are ideally managed and treated by neurological specialists. Neurologists are highly trained physicians with special expertise in the diagnosis of such brain disorders, but they are not always available when a stroke patient arrives at the hospital. Across the country, there are only 4 neurologists for every 100,000 population, and in Mississippi those numbers are even more dramatic.
Neurologist Dr. Ravi Pande is on full-time staff at Greenwood Leflore Hospital and works closely with the Emergency Department physicians and hospitalists to treat most stroke admissions. In addition, in the rare instances where surgical intervention is indicated, Dr. Jimmy Miller and Dr. Craig Clark provide neurosurgical coverage at Greenwood Leflore Hospital . And now, Greenwood Leflore Hospital partners with St. Dominic Hospital of Jackson to provide round-the-clock diagnostic and treatment support for stroke patients through the Delta Primary Stroke Center.
When a patient presents with a stroke, time is of the absolute essence in initiating treatment and limiting mortality and complications. St. Dominic’s offers state-of-the-art remote “telehealth” support, allowing the patient and Greenwood Leflore Hospital physicians to videoconference directly with neurologists in Jackson. These specialists will speak with the patient and collaborate with Greenwood Leflore Hospital staff in the physical examination. Diagnosis and evidenced-based practice guidelines, which have proven to effectively maximize outcomes in their wide-ranging network, will then be utilized. Advances in video technology, assessment tools and medical protocols have combined to make a real impact on the morbidity and mortality of Mississippi’s stroke victims. St. Dominic’s staff will be available to inpatients at Greenwood Leflore Hospital as well as new admissions through the Emergency Department.
Medical information on strokes:
Like every other organ in the body, your brain requires oxygen to survive and function. That oxygen reaches the brain through a network of blood vessels called cerebral arteries. Blood is pumped from the heart up through the carotid arteries, one on each side of your neck, and it then passes through a branching series of smaller and smaller vessels so that every cell in the brain is nourished with life-giving oxygen.
A STROKE occurs when this oxygen supply is cut off to the brain cells. That can happen in two ways: Either a blood vessel is blocked (“occluded”) or it bursts (“hemorrhage”). In both cases, the cells that this vessel should supply no longer have the necessary oxygen and they begin to shut down and, eventually, to die. Think about this like a fireman putting out a fire: If his water hose develops an obstruction or bursts, the water can’t go to where it needs to go. And that can lead to big trouble.
Many medical issues can raise the likelihood of a stroke. ISCHEMIC STROKE, where the blood vessel is blocked, can result from a localized clot in the brain’s blood vessels or a clot traveling from the heart or extremities. HEMORRHAGIC STROKE, where a blood vessel actually bursts, can be caused by a weak spot in the artery or the long- term effects of high blood pressure or atherosclerosis.
Researchers have found that there are multiple risk factors involved in the incidence of stroke. Some of these are genetic or age-related, and can’t be avoided, but others are decreased with healthy life style choices or medication.
Factors that can’t be changed:
Sex: Women are more likely to have a stroke than men.
Age: Strokes are more common in men over 45 and women over 55, but can happen at any age, even childhood.
Race: African Americans are more likely to have strokes than Caucasians.
Heredity: If your relatives have experienced strokes, your risk is often increased.
Prior history: If you have had a stroke or heart attack, your risk will remain higher than for those who have had neither problem.
Medical factors that can often be changed or controlled:
High blood pressure: This is the most critical (and often controllable) risk factor for stroke. If you have a diagnosis of high blood pressure, it is absolutely critical that you take your medication as prescribed and have your blood pressure monitored on a regular basis.
Diabetes: Patients with Diabetes Type I or II are at higher risk for stroke. Good control of blood glucose levels will help to reduce the risk of stroke.
Arterial disease: Fatty deposits (atherosclerosis) in the large arteries leading to the brain or the small arteries within the brain makes these vessels more likely to clot off or become brittle and burst. Peripheral arterial disease can lead to clots, especially in the legs, which can break off and travel to the lungs or the brain.
Atrial Fibrillation: When the heart does not beat smoothly and effectively, small blood clots may form in the upper chambers (the atria). If these break away and go into the bloodstream, they can lodge in one of the small vessels within the brain and lead to a stroke in that area.
Heart disease: Patients who have had damage from a heart attack or who suffer from valve disease or an enlarged heart are more likely to experience stroke.
Sickle cell anemia or other clotting disorders: In these syndromes, the blood tends to clot more readily than it should, which can affect the brain’s vessels.
High cholesterol: Too much cholesterol in the bloodstream will narrow arteries all over the body. If this happens in the brain’s vessels, they can become too narrow for blood to flow through or become so weakened that they hemorrhage.
Lifestyle factors that can increase your risk for stroke:
Smoking: Cigarette smoking is the most preventable risk factor for stroke. Elements in smoke constrict the blood vessels and, over time, cause damage to the interior lining of the vessels, which can lead to clots.
Physical inactivity: Even moderate daily activity can lead to improved heart and vascular health, cutting down the risk of stroke.
Excessive alcohol: Most research shows that more than 1-2 alcoholic drinks per day will increase the risk for stroke in men and women.
Illegal drug use: Drugs like cocaine and heroin directly damage blood vessels and can lead to stroke or heart attack even in occasional users.
When the blood vessels to a certain part of the brain are blocked or burst, the affected area will no longer be able to function properly. There are many different types of strokes, depending on the location of the damage, but the most common symptoms are these:
- Sudden numbness or weakness in an arm or leg, especially if it’s just one side of the body.
- Facial drooping, usually on one side.
- Sudden trouble speaking or confusion.
- Sudden loss of vision or blurred vision in one or both eyes. Sudden dizziness, stumbling or loss of coordination. Sudden severe headache.
Call 911 and ask them to take you to Greenwood Leflore Hospital. Because there are medical treatments available that may minimize or eliminate the damage of stroke, time is critical in getting to a hospital. If signs of stroke are present, do not “wait to see if this gets better.”
If the stroke is ischemic, caused by a clot in a brain artery, a drug called tPA may be administered. This clot-dissolving agent can often eliminate the clot and prevent some or all damage to brain cells, but it must be given as soon as possible. It is very important to note the time when you or your family member began to have symptoms, so that the medical team will know if this treatment is appropriate.
In a hemorrhagic stroke, the location of the bleed and its effect on the surrounding brain tissue determines whether surgical intervention is recommended.
If damage to the brain cells has occurred, the treatment is supportive and often involves rehabilitation to restore strength and use of the affected extremities. Speech therapy may be necessary to help with damage to the brain’s speech areas. Further workup will often be done to determine the cause of the stroke and eliminate or control such risk factors as atrial fibrillation, deep venous thrombosis, high blood pressure and diabetes. Lifestyle changes, such as smoking cessation, weight loss and increased exercise may be recommended.
For more information about The Level II Delta Primary Stroke Center at Greenwood Leflore Hospital, please call 662-459-7191.