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Services
The caring professionals at the SHMC Stroke Center provide:
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Accurate
diagnoses, using state-of-the-art procedures and equipment
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Compassionate treatment across the continuum of care
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Current information for the prevention of stroke
Diagnosis
• Magnetic resonance imaging (MRI) produces a 3-dimensional, detailed image of the head, which is used to pinpoint the size and location of a stroke.
• MR angiography is a thorough MRI study of the blood vessels.
• Computed tomography (CT) perfusion is cutting-edge imaging used to help neurologists determine the best treatment for a stroke patient.
• Transthoracic and transesophageal echocardiography (TTE, TEE) are tests that use ultrasound waves to take pictures of the heart and the circulating blood. They are useful in helping to determine the cause of a stroke.
• Carotid duplex scanning is a test that uses ultrasound waves to take a picture of the carotid arteries in they neck, which carry blood to the brain.
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The NIH Stroke Scale is a test done by certified nurses to assess the extent of injury and to make sure that the stroke has stabilized.
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Neuro
checks, also done by nurses, are a series of questions asked to stroke patients, such as: “What is the date? What time is it? Where are you?” They also test the strength of a patient’s arms and legs. These are ways to monitor the effects of a stroke.
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ABCD2 is the latest tool to help doctors determine whether patients who have had a transient ischemic attack (TIA) should be admitted to the hospital. (A TIA is a “ministroke,” or “warning stroke,” that produces stroke-like symptoms but no lasting damage.) Patients with a score higher than 3 are admitted to the hospital.
TABLE ABCD2
| Symptom |
Score |
| Age older than 60 years |
1
point |
| Systolic blood pressure = 140 mm Hg |
1
point |
| Diastolic blood pressure = 90 mm Hg |
1
point |
| Unilateral weakness |
2
points |
| Speech impairment without weakness |
1
point |
| TIA duration = 60 minutes |
2
points |
| TIA duration 10 - 59 minutes |
1
point |
| Diabetes |
1
point |
Treatment
• Emergency treatment, if necessary
• Medications to prevent blood clots from forming
• Tests to measure blood sugar, risk of heart attack, and the level of oxygen in the blood
• Constant monitoring of vital signs, including heart activity
• Surgical procedures, including
carotid artery stenting,
catheter
ablation, and minimaze to open blocked arteries
• Interventional radiology, a medical specialty where doctors use imaging technologies to discover blockages in arteries and to treat damaged arteries
• Continual monitoring of the extent of injury to be sure that the stroke has stabilized and to prevent complications
• Creation of a plan of care with the help of the stroke care coordinator and speech therapist, physical therapist, and occupational therapist
• Information on self-care, at-home care, family involvement, rehabilitation facilities, and preventing a second stroke
• Physical therapy: relearning to walk, sit, lie down, switch from one type of movement to another
• Occupational therapy: relearning to eat, drink, swallow, dress, bathe, cook, read, write, use the toilet
• Speech therapy: relearning speech and language skills
• Psychological therapy: help in dealing with mental or emotional problems
Prevention
The SHMC Stroke Center provides a wide assortment of resources used in the prevention of stroke.
• Referrals and partnerships with community groups
• Involvement in support groups
• Free publications
• Web sources
• Stroke awareness campaigns
• Expert speakers from the Stroke Center available to make presentations to community groups
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