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Health Information High Numbers, High Standards for Stroke Care

Practice makes perfect, or so the old adage goes. And it's true that the more you do something, the better you become at it. So when a team of doctors sees a high number of patients with a specific condition, it's a pretty good indicator that team members not only know what they're doing, they're doing it very well.

When Dan came to Rush University Medical Center to be treated by stroke specialists, he and his wife, Ruta, were unaware that Rush sees more than 1,000 stroke patients each year. They did, however, have firsthand experience with Rush and knew Dan had been brought to the right place. Months earlier, Ruta had been treated at Rush for what doctors describe as a one-in-a-million type of sinus cancer. "I was thrilled Dan was brought to Rush because I had such a good experience there," Ruta says.

No Time to Lose

Dan came to Rush after suffering the worst headache of his life while shoveling snow. Emergency personnel took Dan to a local hospital, where the decision was quickly made to transfer him to Rush, which has a comprehensive stroke program and has been designated as a primary stroke center by the Joint Commission. This independent, not-for-profit organization accredits and certifies health care organizations and programs throughout the United States.

"Our team of stroke specialists works together to evaluate the situation before the patient arrives; get the patients over to Rush quickly; perform additional testing, if necessary; rapidly put a treatment plan in place; and act on it as quickly as possible," says Sayona John, MD, a neurointensivist at Rush. Since each minute that passes after a stroke jeopardizes brain health, prompt medical intervention for Dan was critical.

In Rush's neurointensive care unit, John and the team set out to identify the source of Dan's condition. Tests found bleeding between Dan's skull and the lining of his brain and a dural arteriovenous malformation — an abnormal tangling of blood vessels in the dense fibrous tissue covering the brain. A relatively rare condition, it was identified thanks to the team's diagnostic expertise.

Step by Step

Before removing the malformation, doctors had to stop the bleeding and prevent further tissue damage. To do this, Michael Chen, MD, a neurointerventionalist, threaded tiny catheters from an incision in Dan's groin up to his brain, where Chen located the artery causing the bleeding. He then used Onyx — a fast-drying, glue-like substance — to stop the bleeding. This procedure set the stage for neurosurgeon Lorenzo Muñoz, MD, to perform surgery, in which he removed blood from the brain and took out the dural arteriovenous malformation.

Dan attributes his good fortune to the dedication and collaboration of his stroke team. Although they treat 1,000-plus stroke patients each year, they gave Dan the prompt, individualized attention he needed to recover fully and return to doing the things he loves.

About the Doctor

Sayona John, MD, is a critical care physician who specializes in helping patients with neurologic conditions, such as strokes, brain hemorrhages, vascular malformations and brain traumas.

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