St. Clair Hospital

Stroke is a life-changing event that affects a person’s body, behavior and communication skills.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it starts to die.

The brain is an extremely complex organ that controls various body functions. If a stroke occurs and blood flow cannot reach the region that controls a particular body function, that part of the body won’t work as it should. Stroke is the third leading cause of death in the United States.

Preventing a stroke by reducing risk factors is best, but when a stroke strikes unexpectedly, quick, appropriate treatment from St. Clair Hospital’s Stroke Care program, which follows the American Heart Association and American Stroke Association guidelines for best practices, can help minimize the stroke’s effect on a person’s body and brain.

Stroke Definition and Causes

Stroke is defined as an interruption of blood flow to the brain. There are two types of strokes: 

Cause		Definition
Ischemic		Begins with the development of fatty deposits lining the blood vessel wall such as thrombosis (blood clot) or embolus (traveling particle).
Hemorrhagic		Occurs when a weakened blood vessel ruptures during an aneurism (ballooning of a weak blood vessel) or Arteriovenous Malformations, or AVMs, (cluster of abnormal blood vessels).

Stroke Effects in Right vs. Left Brain Injury

Brain side		Stroke Effects
Right-sided brain		Paralyzed left side Spatial-perceptual deficits Memory deficits Quick, impulsive behavior
Left-sided brain		Paralyzed right side Speech and language deficits Slow, cautious behavior Memory deficits

 

Risk Factors for Stroke

Other than common risk factors which include age, gender, race, prior stroke and family history, there are many risk factors that could cause a stroke, including:

• high blood pressure
• heart disease
• cigarette smoking
• Transient Ischemic Attacks (T.I.A.s)
• diabetes
• elevated cholesterol levels
• asymptomatic carotid bruit

Warning Signs of a Stroke

• Transient Ischemic Attacks – Also known as mini-strokes or TIAs, these warning strokes can happen before a major stroke and occur when blood flow is temporarily blocked or reduced for a short time.
• Sudden weakness or numbness of the face, arm or leg, especially on one side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble walking, dizziness, loss of balance or loss of coordination.
• Sudden severe headache with no cause.

Prevention and Recovery

Methods of preventing stroke:

• Control high blood pressure
• Prevent heart disease
• Stop smoking
• Recognize the warning signs and call a physician or 911
• Reduce cholesterol levels
• Control diabetes
• Have annual physicals

Methods of recovering from a stroke:

Stroke can cause temporary or permanent weakness or paralysis on one side of the body. A person who has suffered a stroke might have difficulty caring for him or herself and might affect the individual’s vision, memory, speech and muscle strength, as well as the ability to safely drive a car. St. Clair Hospital’s therapists are trained to help people lead independent lives by helping stroke survivors regain their abilities to engage in daily activities.

Stroke rehabilitation is the intervention to minimize impairments and disabilities, to return patients to their home and to begin early rehabilitation.

Highest priorities are to prevent recurrent stroke, minimize complications, ensure proper management of general health functions, and early return to activities of daily living.

Diagnostic Testing

There are a variety of tests that a patient’s physician might order to help him or her determine the best course of treatment for stroke. Some of the most common tests include:

Test		Description
EKG (electrocardiogram)		A non-invasive test that measures the heart’s electrical activity, rate and rhythm.
Echocardiogram		A non-invasive test that uses ultrasound to look at the heart’s blood flow and anatomy.
TEE (transesophageal echocardiogram)		An invasive procedure that uses ultrasound and a tube passed through the esophagus to view the heart’s anatomy and blood flow.
EEG (electroencephalogram)		A non-invasive test that measures and monitors brain wave activity.
CT scan		A non-invasive test that produces detailed pictures of the brain to identify any abnormalities.
MRI/MRA (magnetic resonance imaging)		A non-invasive procedure that uses a large magnet to produce detailed pictures without the use of x-rays.
Holter monitor		A non-invasive, portable test that monitors the heart’s electrical activity for 24 hours.
Carotid Doppler		A non-invasive ultrasound study that measures the blood flow in the arteries of the neck.
Modified barium swallow		An x-ray study of swallowing that identifies where the swallowing difficulty is occurring.
Angiogram		An invasive procedure that identifies the extent, if any, of blockages in the arteries.

Rehabilitation

There are several types of inpatient and outpatient rehabilitation for stroke patients. Inpatient programs include St. Clair Hospital’s Inpatient Rehabilitation Unit and long-term care in a nursing facility. Outpatient rehabilitation includes home-based care and outpatient therapy from physical therapists, occupational therapists and speech therapists. Rehabilitation specialists include:

Specialist		Description
Primary care physician		Primarily responsible for the patient’s hospital care, he or she initiates a treatment plan and coordinates the interdisciplinary team. He or she might order consultations with physician specialists and rehabilitation professionals.
Neurologist		A physician who specializes in diseases of the nervous system. Upon admission, a consult to a neurologist is obtained and the patient is evaluated to determine the extent of the disease.
Cardiologist		A physician who specializes in the treatment of heart disease. Upon admission, a consult might be obtained to rule out a possible cardiac source of the stroke or TIA (mini-stroke).
Physiatrist		A physician who specializes in rehabilitation for post-stroke patients. Assesses patients for any potential complications, oversees continued rehabilitation, and finalizes discharge plans with the patient’s stroke care team and family.
Physical Therapist		Determines area affected by the stroke. Assists in mobilizing the patient. Helps restore physical functions and skills including sitting, standing and walking. Recommends and assists in procuring the appropriate walking devices to improve balance. Recommends the appropriate setting for ongoing therapy after hospital discharge, if necessary.
Occupational Therapist		Recommends home equipment to assist a person with tasks including bathing, dressing, preparing meals and driving. Creates a customized splint to improve hand function, if necessary. Evaluates the home for safety hazards. Provides training that improves the ability to complete daily tasks. Helps a person compensate for vision or memory loss. Provides activities that rebuild self-esteem.
Speech Therapist		Assesses and treats swallowing issues to identify the least restrictive diet. Assesses and treats a person’s ability to communicate effectively. Educates the patient and family about swallowing and communication skills.
Registered Nurses		Initiates, coordinates and facilitates a continuum of care to promote a holistic approach to wellness. Monitors vital signs and neurological status.
Case Manager		Works behind the scenes as a liaison between the patient and the patient’s insurance company to ensure that the patient receives all diagnostic testing and rehabilitation therapies needed to maximize his or her level of functioning after a stroke.
Social Worker		Explores alternatives of care, offers supportive counseling, and provides information regarding community resources. Assists patients and their families with problems resulting from an emergency medical situation, illness or hospitalization.

More Information

For more information on St. Clair Hospital’s Stroke Care Services, please call 412.942.2104 or search for a doctor in our online physician directory.