Caring for the Stroke Patient
What Can We Offer Today?

Unbeknownst to Roberta Van Dorn, a 61 year-old management consultant, a major artier supplying blood to her brain was almost completely blocked. Fortunately, she had a warning sign: transient loss of feeling in one hand. After three episodes, Roberta decided to see neurologist David Levine, MD, at New York University Medical Center. She underwent advanced magnetic resonance imaging and ultrasound studies, which revealed severe blockage of the internal carotid artery and evidence of three small strokes. "Dr. Levine didn't pull and punches," Roberta recalls. "I was a major stroke waiting to happen. Fortunately, the blockage was surgically correctable." Dr. Levine referred Roberta to Thomas Riles, MD, Chief of Vascular Surgery, who performed an urgent carotid endarterectomy. Roberta was discharged the next day and returned to work shortly thereafter.

Treating a Stroke in Progress

In recent clinical trials, selected patients benefited from injection of a thrombolytic (clot-dissolving agent during a stroke. Success in the use of thrombolytic therapy requires quick and accurate decisions by experienced clinicians. For this therapy to be effective, patients must arrive at the emergency room shortly after symptoms begin, and hemorrhage must be ruled out as a cause - which requires computed tomography (CT) in the emergency room.

Preventing Another Stroke

Determining the cause of each patient's stroke helps prevent another one, says neurologist Govindan Gopinathan, MD. "This requires a team of expert diagnosticians, meticulous procedures, and the best equipment.

Treatment Strategy

Unfortunately, things don't always work out so well. Storke is a leading cause of disability and death in United States. prevention efforts focus on reducing risk factors such as hypertension, obestiy, high cholesterol, and lack of exercise. When prevention fails, treatment of stroke has three objectives.
1) minimize damage while the stroke is in progress
2) treat the underlying causes to prevent another stroke
3)rehabilitate the patient by building on strengths that remain.