The stroke program at Hoag offers a rapid response stroke team comprised
of emergency room physicians, neurologists, neurosurgeons, neuroradiologists,
specialty-trained nurses and other critical support staff. The hospital’s
on-site neurology hospitalists and interventional neuroradiologists offer
patients an even higher level of specialized care.
The stroke team quickly evaluates and treats patients utilizing the latest
in leading-edge diagnostic, treatment and interventional techniques. The
sooner patients receive appropriate stroke treatment, the better their
chances for survival, and for suffering the least amount of permanent damage.
Equipped with state-of-the-art diagnostic imaging technologies, Hoag physicians
are able to quickly assess stroke and determine the best possible treatment
for stroke patients. Sophisticated brain imaging provides detailed pictures
of affected areas including cerebral structures and blood flow. These
images allow Hoag clinicians to diagnose and treat stroke within minutes,
and with greater precision, resulting in improved patient outcomes.
The stroke team utilizes Hoag’s highly advanced multi-detector 64-slice
CT as well as Hoag’s state-of-the-art 3Tesla MRI scanners, which
provide exquisite detail of subtle brain function and structure using
vascular, anatomic and physiologic imaging, displaying these in three
Angiography and ultrasound are also used to detect blocked blood vessels
and areas where the brain is affected, as well as to guide treatment.
As a leader in acute stroke care, Hoag provides a full range of minimally
invasive endovascular techniques for both the prevention and treatment
of stroke. Early detection of stroke risk includes the use of ultrasound
to look for silent blockage in the arteries leading to the brain.
Carotid stenting is a preventive procedure for certain high-risk patients
with such blockages, where post balloon angioplasty, a sleeve made of
fine metal mesh, or stent, is fitted inside the newly opened carotid artery
in order to hold the artery open and restore blood flow to the brain.
Hoag also specializes in preventive treatment of potentially explosive
weak spots in the arteries of the brain. Such weak spots, or aneurysms,
can be found on CT or MRI scans. Endovascular coiling or injection of
other substances may be a treatment option for patients with hemorrhagic
stroke—the type of stroke caused by bleeding in the brain either
due to an aneurysm or other blood vessel malformations.
Innovative Stroke Treatment
More than 80% of all acute strokes are caused by blood clots. One treatment
option for stroke is Tissue Plasminogen Activator (tPA), a medication
that helps dissolve blood clots. To be effective, tPA must be administered
within three hours from the onset of symptoms. And since the average patient
is brought to the emergency room between three and six hours after the
onset of symptoms, intravenous tPA is administered to approximately two
percent of patients nationwide. That's why it's so important for
individuals to seek immediate emergency treatment at the first sign of stroke.
The recently FDA-approved Penumbra device provides an effective treatment
option which can be used up to eight hours after the onset of symptoms
to open blocked vessels. Armed with the new Penumbra System and an extended
treatment window, Hoag Hospital neuro interventionalists are successfully
helping a broadened patient population to improve neurologic recovery
and reduce the incidence of disability resulting from acute ischemic stroke.
The Penumbra system is comprised of a catheter, separator and aspiration
device. In the treatment of acute ischemic stroke, a catheter is guided
to the site of the blood clot while the separator, fed through the catheter,
continuously breaks up the clot while the aspiration pump vacuums the
clot debris from the blocked vessel.