Stroke Services

Good Samaritan Hospital’s stroke services have the critical elements necessary for improved outcomes for patients.

Diagnosis

It is crucial that our physicians determine whether stroke is ischemic (caused by a blocked brain artery and the resulting insufficient supply of blood to part of the brain) or hemorrhagic (caused by the rupture of a brain artery and bleeding into or around the brain) before appropriate treatment can begin. Other possible causes of symptoms that mimic stroke, such as a tumor, seizure or infection, must also be ruled out.

Working with many diagnostic tools, experienced GSH physicians can determine the precise location of stroke, its cause, and how much damage resulted from the stroke to make essential treatment decisions quickly.

Diagnostic Tools

Diagnostic tests and procedures are vital tools that help GSH physicians confirm or rule out the presence of a neurological disorder or other medical condition.

Stroke experts across Premier Health use telemedicine - a powerful new tool to speed definitive care to patients experiencing acute strokes. GSH has telemedicine devices in its Emergency Trauma Center and Intensive Care Unit. These devices allow the team of stroke neurologists to consult remotely using a two-way video terminal wheeled to the patient's bedside. From their own notebook computer, the neurologists can “see” the patient, ask questions and view CT scans - all in real-time - to assess the patient's condition and help the on-site physician determine if the patient is a candidate for clot-dissolving medication or another form of acute stroke therapy.

Physical Examination - Good Samaritan physicians listen to the heart, look at the eyes, and do a general exam to evaluate the patient for other signs of vascular disease. A stethoscope may be used to listen for a bruit (an abnormal sound produced by turbulence in one of the two main arteries that supply blood to the head). A bruit often indicates atherosclerosis (fatty deposits that block the flow of blood through the arteries).

Basic Laboratory Tests - In addition to checking blood pressure and cholesterol levels, doctors at Good Samaritan may test patients for diabetes and check the blood for an elevated level of the amino acid homocysteine. A high level of homocysteine may be associated with an increased risk of cardiovascular disease and is a risk factor for stroke. Homocysteine levels may be modified with certain treatments.

Computed Tomography (CT) - CT scans are generally the first diagnostic test completed when a patient with suspected stroke arrives in the emergency department. CT scans are used to distinguish between ischemic and hemorrhagic stroke. The test involves low-dose X-rays and allows physicians to visualize the brain.

Computed Tomography Angiography (CTA) - In CTA, dye is injected into the blood vessels. X-ray beams then create a three-dimensional image of blood vessels in the neck and brain. CTA is used to identify aneurysms, arteriovenous malformation, and arterial narrowing.

Magnetic Resonance Imaging (MRI) - MRI uses a strong magnetic field to generate a three-dimensional view of the brain. MRI is used to detect an area of brain tissue damaged by ischemic stroke. It provides a high level of anatomic detail to help physicians precisely locate the stroke site and determine the extent of damage. MRI procedures are performed in a special room free of metallic equipment for safety.

Magnetic Resonance Angiography (MRA) - MRA is a noninvasive technology that images the cerebral (head) arteries and veins. It also yields valuable information regarding other arteries supplying the brain. This procedure uses a strong magnetic field similar to MRI.

Carotid Ultrasonography - In this ultrasound of the neck, sound waves pass through tissue and then return, creating on-screen images. These images show any narrowing or clotting in the carotid (neck) arteries and how fast blood is flowing through them to the brain.

Positron Emission Tomography (PET) - PET scans measure brain cell metabolism to show whether the brain tissue is functioning, even though blood flow to that area appears diminished.

Arteriography - Arteriography produces a detailed view of arteries in the brain that are not normally seen in X-rays. A catheter is inserted in an artery of the arm or leg. Dye is injected into the blood vessels leading to the brain. X-ray images show any abnormalities of the blood vessels, including narrowing, blockage, or malformations.

Echocardiogram (ECG) - ECG is an ultrasound of the heart. It is conducted to determine whether an underlying heart problem is contributing to the risk of stroke. In ECG, a transducer (wand-like device) collects echoes (reflected sound waves) from the heart and transmits them to a machine. The ultrasound probe may be placed on the chest or a small tube may be inserted down the throat.

Treatment

Stroke is categorized into two main types: ischemic stroke and hemorrhagic stroke. Each type is treated differently but, in general, stroke treatment involves three stages:

• Prevention
• Medication and surgery
• Rehabilitation

Learn more about stroke treatments at the American Stroke Association  website.

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