Why timely action is critical for stroke patients

The Medical City

Posted at Sep 04 2019 05:13 PM | Updated as of Sep 24 2019 11:47 AM

It was just like any other dinner party for Lita, 66, and her daughter Nellie, when it suddenly struck: the warning signs of a stroke. 

"When my mom was handed a plate, she suddenly dropped it. She did not feel anything but when we were talking to her, we noticed that she was slurring her words already. When we asked her to stand up, she couldn’t stand on her own because her right side was already weak. So in just a matter of minutes, we rushed my mom to The Medical City. We left the place at 7:30 p.m. and arrived at the ER at around 8:15 p.m.," Nellie said. 

What happens to your body leading to a stroke, and how long does one have at the onset of one? 

A stroke's medical definition is that of an emergency where the blood delivered to the brain is interrupted in either of two ways: blood clot or bleeding. In case of the former, where there is a blockage of the blood vessel inside the brain, a procedure called thrombolysis is often performed, with the aim of restoring the circulation of blood in the brain. If done within the so-called 'golden period' of 3 to 4.5 hours, this could be successful. 

During a stroke, immediate location of the clot through CT Scan of the Brain is important to determine the proper intervention needed

In this limited window to save a life, doctors at The Medical City’s [[BOLD]Institute of Neurological Sciences] are capable of the delivery of a management or procedure for stroke patients with an extended window of opportunity beyond that of 4-and-a-half hours for thrombolysis. 

Mechanical Thrombectomy (MT) can be done beyond 4 1/2 hours up to 12 hours. It is an invasive therapy to extract the clot that has blocked a large blood vessel inside the brain to restore cerebral blood flow and save the remaining unaffected brain tissue deprived of blood circulation. 

Before the advent of Mechanical Thrombectomy, patients with severe stroke who presented beyond the golden period for thrombolysis would have no other recourse but routine medications to lower the chances of stroke recurrence.

Just as with any child, Nellie was worried about her mother. She brought her mother to the right place as recommended by her uncle who is also a doctor. 

At the Emergency Department, The Medical City Brain Attack team provides rapid assessment and care to patients showing signs of impending stroke.

At the emergency department, Lita was assessed by the Brain Attack Team and Dr. Jo Ann Soliven, a stroke neurologist, confirmed that Lita had indeed suffered a stroke and recommended thrombolysis. 

While the clot-buster medication was being administered, further diagnostic tests were done and showed a clot that was blocking an artery in Lita’s brain, hence Mechanical Thrombectomy was offered.

Dr. Erwin Jocson, an interventional neuroradiologist was called into the case and MT was performed as soon as possible. 

Jocson said they found that the blood vessels in Lita's brain are already badly damaged. But with both the clot-buster medication and clot retrieval procedure, doctors were able to prevent massive brain injury. 

"We saved significant functions such as her ability to speak," Jocson said. 

The Medical City is a stroke-ready hospital capable of the latest globally recommended management for stroke. 

It has a dedicated Brain Attack Team specialized in speedy neurological assessment, emergency, and acute stroke management, care and monitoring. 

Close monitoring of the patient's recovery is done by specialists at the Acute Stroke.

It also has an equipped Acute Stroke Unit and a dedicated Neuroscience ICU where patients are cared for by a multidisciplinary team of stroke neurologist, neurointensivist, medical intensivist, neurologists, neurosurgeons, endovascular surgeon, interventional neuroradiologist, and specially trained stroke nurses, collaborating with other medical specialists, physical and occupational therapists, pharmacists, nutritionists, and respiratory therapists.

This team is guided by internationally recommended, evidence-based but locally applicable treatments or interventions.

Two weeks later, Lita is still wheelchair-bound but can tolerate 20 minutes of standing up on parallel bars and can reply to queries in complete and coherent sentences as observed during her session at the rehab center. 

The well-equipped rehab center at The Medical City is where stroke patients undergo therapy and post-operative treatment monitored by dedicated specialists. 

Soliven is thankful for both the family and the TMC team. 

"These we credit to the family's knowledge that stroke is an emergency and that time is of the essence. Credit also goes to the Brain Attack Team for fast and accurate detection and to all members of the stroke team for quick and efficient actions," she said. 

The Medical City remains steadfast in its mission to be the trusted healthcare facility, and one of its many thrusts has been to continually seek the best and latest technology for optimal treatments of global standards. In this case, stroke patients are given a better, stronger fighting chance of not only saving their lives but having good neurologic outcomes.

Preparation and knowing how to act and who to call have saved lives. TMC’s emergency hotline is 689-8153. To know more about the services of the Department of Neurology, Institute of Neurological Sciences, please call 9881000 ext. 6270.

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