After treating hundreds of stroke patients, Dr. Sheryl Martin-Schild of Tulane Medical Center in New Orleans knows both the elation and tragedy experienced by stroke victims. For many victims, life and death is a matter of only four-and-a-half hours. That's the window of time in which the miracle drug t-PA can be effective in treating a stroke, and possibly offering the best-case scenario for a stroke patient to regain his or her life.
"The most important things for people to know are how to recognize a stroke when it happens , and that it is treatable," says vascular neurologist, Tulane professor and Director of the Tulane Stroke Program, Martin-Schild.
Signs and Symptoms of Stroke
According to the National Stroke Association, the signs and symptoms of stroke include:
- Sudden numbness or weakness of the face, arm or leg – especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headaches with no known cause
If You Experience Stroke Symptoms, Call EMS
Martin-Schild explains how a stroke code is handled at Tulane Medical Center, a certified Primary Stroke Prevention Center located in the "stroke belt," an eight-state region in the southeastern U.S.
"We receive pre-hospital notification for about 90 percent of our stroke patients," says Martin-Schild. "The EMS worker sees the patient and says, 'I think this is a stroke,' and calls the emergency department."
That call sets off a cascade of paging calls, which not only alert the stroke specialists like Dr. Martin-Schild and her team, but also clears the path for immediate access to CT (computed tomography) services and critical lab procedures.
"We're usually there, waiting as the patient rolls in the door," says Martin-Schild. "Seventy-two percent of our stroke patients are treated within 60 minutes."
The remaining 28 percent usually can't speak well enough to provide the necessary information to the medical team. They normally have no one with them who can speak for them.
The Race to Save the Brain
"A stroke or 'brain attack' occurs when a blood clot blocks an artery (blood vessel that carries blood from the heart to the body and brain) or an artery breaks, interrupting blood flow to an area of the brain. When either of these events occur, brain cells begin to die and damage occurs," according to a Tulane Medical Center brochure.
About two million brain cells die per minute, so it's a life or death race to get the blood flowing to the brain.
Damage to the brain can result in someone losing abilities for speech, movement and memory. In fact, strokes rank as the leading cause of disability in the U.S. and the number three cause of death.
Stroke Treatment Advances
Dr. Martin-Schild exclusively treats stroke patients. Although she acknowledges that each patient is unique and that stroke severity and risk factors vary widely, she is adamant that even a severe stroke may be treated effectively – if treated quickly – using specific medical protocols and advanced neuroimaging technology.
"Patients...come in with devastating strokes...and they get to us in a timely fashion before there is evidence that their brain has had too much damage," Martin-Schild says. "Then we'll be super aggressive with them – giving them the clot busting IV (intravenous) if they meet our criteria."
In some cases, Martin-Schild has been able to apply clot busting medicine directly on the clot, or pull the clot out with a corkscrew device, or even use a high-tech little vacuum, which enables the vascular neurologist to suck up the clot.
"It’s very rewarding to see the clot fall into the canister, and then see that the patient’s blood vessel has reopened," Martin-Schild says.
Stroke Prevention
Since high blood pressure tops the list of risk factors for a stroke, Martin-Schild urges people to manage their blood pressure.
"If I could control everyone's blood pressure, then that would eliminate 45 percent of strokes," she says.
In addition, there are a number of possible procedures and surgeries available to prevent strokes, she says. Patients should always be proactive in seeking treatment.
Stroke Education
Nationally, only about 3 percent of stroke victims get treated in the critical four-hour window. That's unacceptable to Dr. Martin-Schild. She's on a mission to educate people about stroke symptoms, treatment and prevention.
Only 20 years ago, doctors gave stroke victims little more than aspirin and some rehabilitation. Now, she describes the medical discoveries for stroke treatment as "exploding."
Armed with this knowledge, she works to help as many stroke victims as possible. Duty may have robbed her of countless nights of sleep, but she's not about to give up.
"Every time we sit there and watch a patient improve in front of our eyes, it's the driving force to getting up the next 100 times and trying – because we can’t make a difference every time, but we can try every time. It’s important to someone – otherwise they have no option."
Cheryl Settoon - Cheryl Settoon - former TV producer and managing producer turned academic who writes business, communication and media stories.
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