From emergency to recovery: complete stroke care

John Fier is in the lifesaving business: He works as a supervisor for the Chicago Fire Department and has helped countless people during his career. But in February 2005, the tables turned, and it was Fier who needed to be saved.

When Fier went to work one morning experiencing dizziness and other symptoms of an impending stroke, his firehouse colleagues wasted no time driving him to the Rush University Medical Center in Chicago’s emergency department, where a new approach to stroke prevention may have helped save his life.

Every minute counts
Stroke is the third leading cause of death in America and the leading cause of adult disability. It occurs when a clot, plaque buildup or a broken blood vessel deprives the brain of blood. Stroke requires immediate medical care. Every minute that passes puts a person at greater risk for disability or death.

To learn about some of the common signs of stroke, read “Stroke Warning Signs.”

At Rush, home to one of the nation’s leading neuroscience programs according to U.S.News & World Report, the stroke team does everything possible to make the most of those minutes, using the latest, most innovative stroke treatments available.

It was one of those treatments — a small flexible tube called a stent that props open a blood vessel — that may have helped save Fier’s life.

In fact, Fier was among the first patients to benefit from a stent used in the brain. Until recently, stents were commonly used in the heart to help treat clogged arteries, but it was rare to use them in the brain’s more fragile, tangled vessels. Now Rush uses a new stent designed specifically for the brain.

Surviving stroke
Back at work and living a normal life, John Fier is one of the lucky ones. Each year, 163,000 Americans die from a stroke. And about 4.8 million Americans are living with the effects of stroke, which can include paralysis, memory problems, inability to read or write, problems speaking and understanding language, weakness in the arms and legs, and vision problems. While people can survive a stroke, their quality of life often depends on the quality of their rehabilitative care.

Rush offers the most comprehensive stroke care available. At every step, from emergency treatment through rehabilitation, Rush offers innovative, top-of-the-line services, says Shyam Prabhakaran, MD, a stroke neurologist at Rush.

“It’s a program with a lot of expertise and a lot of energy,” he says. “In the emergency room, we’re pushing the envelope of what can be done to help people with stroke. In intensive care, we have state-of-the-art technology, and we have great follow-up and rehabilitative care to help patients regain a good quality of life.”

In the fight against stroke, the team of stroke neurologists, endovascular neurosurgeons and neuroradiologists at Rush provides both standard and innovative therapies, such as clot-busting drugs and newer devices to treat acute ischemic and hemorrhagic stroke. Comprehensive stroke care at Rush involves intensive prevention strategies to reduce stroke recurrence plus aggressive rehabilitation, including occupational, physical and speech therapies. Early rehabilitation can decrease disability after stroke and reduce stroke-related complications.

Determine your risk
John Fier had an elevated risk for stroke because his father died of a stroke at 53 — the same age as Fier when he experienced warning signs. According to Prabhakaran, understanding your risk for stroke is vital to reducing it. Risk factors for stroke include

• Family history
• Age (stroke risk more than doubles each decade after age 55)
• Heart problems
• Having a history of transient ischemic attacks (TIA)

A TIA is a “ministroke,” which causes strokelike symptoms that begin suddenly and only last a few minutes, and generally less than one hour. If you have experienced TIAs, you should see a stroke neurologist immediately. TIAs are a warning sign that you could have a full-fledged stroke.

Reduce your risk
You can reduce your risk for stroke by

• Not smoking
• Controlling high blood pressure and cholesterol
• Managing diabetes
• Exercising regularly
• Maintaining a healthy weight
• Not abusing alcohol or drugs

Discuss your risk factors with your primary care doctor. You may need additional screening, which can include the use of sophisticated imaging technology to look for narrowed or blocked arteries in the brain.

Once your risk level has been determined, the stroke services team at Rush can help you find ways to reduce it. Prevention methods, such as lifestyle changes, medications and surgical procedures, may be recommended.

For more information about stroke and the prevention, treatment and rehabilitation options available at Rush University Medical Center in Chicago, visit www.rush.edu/discover. If you have experienced strokelike symptoms, call (888) 352-RUSH (7874) to schedule an appointment with a stroke neurologist.

Read about a new clinical study at Rush on a new device that may be able to help people with strokes by physically removing blood clots from the brain.

For information on other clinical trials for stroke, go to the Nervous System Disorders area of the Rush clinical trials site.