The Power Of Teamwork: Vascular Center

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  This special advertising section content provided by Massachusetts General Hospital

Stroke is the third leading cause of death in the United States and the number one cause of long-term disability. Stroke is a vascular disease that results when blood vessels in or near the brain are blocked by a blood clot (a thrombosis) or they rupture.

During a stroke, blood flow in the brain is blocked. Brain cells die because they are deprived of oxygen and nutrients. Depending on the severity and location of the stroke, patients experience short- or long-term physical and mental limitations. These may include paralysis, difficulty with speech, memory loss, difficulty thinking or coma. One-third of stroke cases are fatal.

TYPES OF STROKE
Ischemic strokes are most common. Caused by plaque (a build up of fatty deposits also known as atherosclerosis), two types of blood clots can form: a cerebral thrombosis in a clogged blood vessel in the brain. Or a cerebral embolism in the heart, chest or neck that breaks free and travels to the brain. Atrial fibrillation is an irregular heartbeat that can cause blood clots in the heart that can dislodge and travel to the brain.

Hemorrhagic strokes occur in 1 in 5 stroke cases. Hemorrhagic stroke involves weakened or bulging blood vessels, also called aneurysms, or when a cluster of malformed blood vessels called arteriovenous malformations occur. Both types of blood vessels abnormalities compress brain tissue and can cause an intracerebral hemorrhage (bleeding in the brain) or subarachnoid hemorrrhage (bleeding outside the brain).

Transient ischemic attacks (TIA)-are mini-strokes that affect about 6% of the population. TIAs are considered a warning sign for stroke. One in three people with TIA will have a stroke, half of those people within a year of having a TIA. TIAs are caused by blood clots from plaque build up, but the decreased blood supply to the brain that results is only temporary. This situation usually corrects itself, but people with TIAs must take precaution immediately to avoid a stroke.

SIGNS OF STROKE
Stroke symptoms can appear suddenly. Call 911 immediately if you recognize any of these signs in yourself or others. The sooner stroke is diagnosed and treated, the better the chances of minimizing long-term ill health effects.

Symptoms of stroke or TIA may include:
• Numbness or weakness of the face, arm or leg, especially on one side of the body
• Confusion, trouble speaking or understanding
• Difficulty seeing in one or both eyes
• Difficulty walking
• Dizziness
• Loss of balance or coordination
• Severe headache of unknown cause

WHO'S AT RISK FOR STROKE?
We're all at risk for stroke if we don't maintain a healthy lifestyle. But some groups are more at risk than the general population. Help control your risk.

Talk to your doctor and do the following:
• Eat a healthy diet and watch your cholesterol and blood pressure
• Don't smoke or abuse alcohol
• Maintain a healthy weight and exercise regularly
• Do your part to manage diabetes and atrial fibrillation
• Talk to your doctor about taking aspirin or if you have sleep apnea
Some people have risk factors for stroke they cannot control. Talk to your doctor to learn more if you:
• Have cardiovascular disease, or a prior stroke or transient ischemic attack (TIA)
• Have vascular disease, such as peripheral arterial disease (PAD),
carotid artery disease (CAD) or aneurysm,
• Are age 60 or older
• Have family history of stroke
• Are of African American, Hispanic or Asian descent

DIAGNOSING AND TREATING STROKE
A stroke is an emergency situation. If the brain is starved of oxygen for too long, its cells die quickly. This can result in permanent damage. Fast and accurate diagnosis is the most important first step.

CT technology, including the new, state-of-the-art 64 slice CT scanner is the preferred imaging tool to diagnose the cause, location and extent of stroke damage. Other imaging tests, such as X-ray, MRI, Duplex Ultrasound and other tests may be ordered depending on a patient's case. After diagnosis, specialists move quickly to stop the bleeding in a hemorrhagic stroke or eliminate a clot in an ischemic stroke.

Treatment options include clot-busting medications, oxygen support and frequent neurological exams. Surgery may be required, including a carotid endarterectomy, removal of fatty deposits in the neck's major arteries; or an extracranial/intracranial bypass to reroute the blood supply around a blocked artery. Your doctor may also recommend a tPA (tissue plasminogen activator) that uses catheters to dissolve blood clots in the brain. Rehabilitation may include physical or occupational therapy, and speech therapy.

STROKE CARE
Nowhere else in the country can you find all the resources and specialty clinical expertise necessary to prevent, diagnose and treat stroke. The Massachusetts General Hospital Neurology Stroke Serviceis the nation's oldest and largest program. Our Vascular Center brings together seven clinical disciplines to advance clinical care, education and research in stroke. US News & World Report ranks the neurology service among the nation's elite. Our Stroke Research Center and commitment to training the future leaders in stroke care distinguish our care from all others'.

Stroke Services include:
• Acute stroke service
• Inpatient and outpatient programs
• Stroke consult service
• Pediatric stroke
• Spaulding Rehabilitation Hospital
• Cerebrovascular Laboratory
· Telestroke program

Innovation in technology, treatment and research distinguish the Massachusetts General Hospital Vascular Center. We are unmatched when it comes to providing oustanding patient care, training tomorrow's leaders in vascular medicine and laboratory and clinical research programs. To learn more, including advanced care options or to make an appointment, please call 877-MGH-8346.

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