When someone appears to have suffered a stroke — showing symptoms such as partial paralysis, impaired speech or loss of vision — it’s important to get him or her to a doctor as quickly as possible. The sooner he gets medical attention, the better his prospects for effective treatment and recovery.
But at the receiving end, where the physicians and surgeons evaluate the patient, the window for effective treatment has widened. And doctors like Yi Mao, M.D., a Providence stroke neurologist in Spokane, say that many more patients are now eligible for treatments and potentially recover from the effects of stroke than previously was possible.
The window for successful treatment has recently widened to 24 hours, and perhaps beyond. The breakthrough is in the advanced imaging technology that helps health care providers see if the patient is a candidate for the clot retrieval procedure.
“We recently had a patient who came to the hospital and was paralyzed completely on the right side,” said Dr. Mao. “Couldn’t see. Couldn’t speak.”
But Dr. Mao and his team, working in conjunction with emergency and interventional radiology physicians, determined very quickly that the patient would benefit from treatment, and clot retrieval was performed in a timely fashion. Dr. Mao says the patient recovered very well, with only relatively minor deficits remaining that is expected to improve further with rehab therapy.
The DAWN breakthrough
Dr. Mao participated in a trial called DAWN, in which providers combined advanced imaging techniques with clot extraction using a device made by Stryker. By determining which patient are likely to benefit from treatment, and applying a device to penetrate and extract a blood clot in a minimally invasive way, doctors were able to treat patients far beyond the old three- or six-hour windows.
Now, said Dr. Mao, the imaging-and-extraction treatment tested in the DAWN trials “is considered standard of care.”
It has added a new dimension to a care team’s ability to determine whether a patient is a candidate for the treatment. It is far more precise than the cruder measure of how much time has elapsed between the stroke onset and the patient’s arrival at the emergency room.
It answers the question “How do we better select patients?” said Dr. Mao. It has benefited “many, many patients,” some of whom would not have received treatment and not recovered as well prior to the DAWN trial, he said.
It means, for example, that someone who suffers a stroke after going to bed may still be a good candidate for successful treatment when she wakes up eight hours later.
Symptoms of stroke
Even with a stroke patient’s extended opportunity for recovery, it’s critical to get him to emergency treatment as quickly as possible. Here are some of the symptoms that may accompany a stroke:
- Sudden numbness or weakness in the face, arm or leg, especially if it occurs on just one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing
- Sudden trouble walking, lack of coordination or loss of balance
- Sudden severe headache
If these symptoms are present, call 9-1-1 immediately.
If you’re not sure if a stroke has occurred, take these easy-to-remember steps:
- Ask the person to smile. Is one side of her face drooping?
- Ask her to raise both arms. Does one arm drift downward?
- Ask the person to repeat a phrase. Is his speech strange?
- Time: Call 911 immediately if any of the above signs are present and make a note of the time when the symptoms began.
Dr. Mao says it’s tremendously rewarding to see patients bounce back from strokes that might have debilitated them 10 years earlier.
“That’s why we do this,” he said.
If you’d like to talk to a Providence provider about stroke treatments or anything else, you can find one near you in our online directory.
AK: Providence Heart & Vascular Center
CA: Providence Neuroscience Services
MT: International Heart Institute of Montana
OR: Providence Heart & Vascular Institute; Providence Brain & Spine Institute
WA: Providence Neurology & Neurosurgery; Swedish Neuroscience Institute
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.