What you need to know about strokes

THS

Trident Health System offers comprehensive cardiovascular and cerebrovascular programs including diagnostic tests, catheterization, critical care, telemetry, and cardiac rehabilitation, in addition to a support group for stroke patients and their caregivers.

According to Dr. Thomas Privett, a neurology hospitalist at Trident Health System, stroke is the most common severe neurological disorder in the United States, being the third leading cause of death after heart disease and cancer.  Stroke is relatively uncommon before age 50, but the occurrences double each decade after age 55.  The long term effects of a stroke, he explained, are dependent upon the size and location of the stroke in the brain, with the most common symptoms being numbness or weakness to one side of the body, difficulty speaking, understanding words or any combination of these symptoms.  “The symptoms usually are abrupt in onset and involve a decrease or loss of function or sensation,” Dr. Privett said.  “A stroke can occur at any time but the majority of strokes occur in the morning hours,” he added.

If a person experiences these symptoms, he or she should call 9-1-1 and go to the Emergency Room since there are multiple treatment options.  “Blood pressure is often elevated and appropriate management can improve the outcome,” said Dr. Privett. “If a patient meets clinical criteria, they may be treated with a thrombolytic (or clot-busting) drug.  But they must be evaluated and the drug started within three hours of stroke symptom onset.”

When a person is admitted to the ER with a stroke at a Trident Health System facility, Dr. Privett is consulted to assist in the diagnosis, evaluation and treatment of the stroke.  Trident Health System is the only hospital in the Charleston area which has a neurology hospitalist on staff. The benefit to the patient is less delay in neurological evaluation since Dr. Privett does not have to shift back and forth between clinic and hospital.  

Uncontrollable factors such as family history place some people at higher risk for stroke than others.  But most people can reduce their risk by making lifestyle changes. According to Dr. Privett, hypertension increases a person’s risk by seven times. Heart disease, diabetes and smoking each double the risk of stroke, while elevated cholesterol increases the risk of both stroke and heart disease.  “The risk or presence of each of these can be modified by stopping smoking and avoiding second-hand smoke, improving one’s diet and participating in a low-impact exercise like walking.  It is also important to be evaluated by a primary care physician for the appropriate screening tests, medication if needed and to develop a plan for a healthy lifestyle,” he said.

As much as 88 percent of stroke patients will have weakness on one side of the body when they experience a stroke. Patients with milder strokes recover more quickly, but 95 percent achieve their best neurological outcome within 11 weeks of stroke onset.  “Recovery of strength will reach a plateau after an early phase of progressive improvement, so it is important to continue therapy even after the plateau to maintain that improvement,” Dr. Privett said.  He added that rehabilitation with physical therapy, occupational therapy and speech therapy begins as soon as possible.  When medically stable, the patient is evaluated for transfer to the appropriate rehabilitation program.

When some stroke patients are discharged from the hospital, they may receive assistance through outpatient rehabilitation for any additional services needed and permanent treatment is coordinated through the primary care physician.  Patients who do not have a primary care physician are referred to a physician through the hospitalist service, or social services works with the patient to establish outpatient follow-up.
 
Trident Health System offers a Stroke Support Group for stroke patients and their caregivers.  The group meets the second Tuesday of every month from 6:00 to 7:30 p.m. in the Community Classroom at Summerville Medical Center.  For more information about cardiovascular and cerebrovascular services at Trident Health System, or about the Stroke Support Group, visit www.tridenthealthsystem.com.