Timing is Everything

July 11, 2016 Johnson Moon, MD


St. Jude’s Advanced Comprehensive Stroke Center is Ready to Treat Stroke Victims Fast

Every year 795,000 people in the United States have a stroke, according to the Centers for Disease Control, and nearly 130,000 Americans die from a stroke.

If Johnson Moon, MD, had his way, we would all recognize the signs of stroke as readily as we do the signs of a heart attack, and we’d treat it just as urgently – with an immediate call to 911.

Getting treatment for a stroke fast is critical to recovery, says Dr. Moon, a board-certified neurologist and the medical director for the stroke program at St. Jude Medical Center, an Advanced Comprehensive Stroke Center – one of only ten hospitals in California to have earned this prestigious designation.

Most strokes are the type called ischemic – when a blood clot forms in a blood vessel in the brain. “A blockage causes cells in the brain to starve for blood, which decreases their function,” says Dr. Moon. “This causes stroke symptoms, and the longer the cells are starved for blood, the smaller the chances that the patient will recover or heal.”

A powerful medication given to a person having a stroke is called TPA (tissue plasminogen activator). “It helps break down the clot and improves outcomes,” says Dr. Moon. Patients meeting the criteria who receive this medicine within four hours of showing stroke symptoms will have much improved chances of recovery.

Strokes can result in long-term disability, which is why recognizing the symptoms – in yourself or in someone else – and then getting treatment quickly, is so important. To help people remember the symptoms, the American Stroke Association came up with the acronym FACT.

Symptoms to watch for

“F” stands for sudden face droopiness on one side, says Dr. Moon. “A” stands for arm weakness or numbness. A standard check for a possible stroke is to ask the patient to lift both arms to equal height to see if one arm hangs lower. “S” stands for speech abnormalities – garbled or words or an inability to speak. And “T” stands for treatment, the reminder that fast treatment makes a big difference in outcome.

“If you suddenly feel that something is not right,” says Dr. Moon, “if you suddenly have poor balance or are seeing double or can’t see at all, these are signs of a possible stroke.”

Upon arriving at an emergency department, patients are assessed, and if it is determined that they are having a stroke, they will receive a head CT scan, and possibly 3-D advanced imaging that will create images of blood vessels in the brain. “One exciting new treatment that interrupts the stroke is one in which the neurointerventionalist inserts a catheter in the groin that goes up to the brain and extracts the clot,” says Dr. Moon.

Another kind of stroke, called hemorrhagic, happens when a blood vessel ruptures and blood leaks into the brain. Though the symptoms are similar, the treatments in this case aim to stop the bleeding and minimize damage from the hemorrhage.

The advantage of reaching out to a 24-hour comprehensive stroke center is clear: immediate diagnosis and treatment by trained experts. “From emergency department to rehabilitation, we offer a superior, multi-disciplinary care program,” says Dr. Moon. “Our doctors, surgeons, technologists, nurses and therapists are especially trained in stroke care.”

Who has strokes?

Contrary to common belief, anyone of any age can have a stroke, according to Dr. Moon, even children and teenagers. It is true that the older the person, the higher the risk of stroke. “The average age of a patient with their first stroke is in the 60s to 70s,” he says.

Other risk factors that are not in our control include genetics, being African American, Hispanic and/or being female. These groups face a higher risk of strokes.

Modifiable risk factors, as Dr. Moon calls them, are the ones to focus on. High blood pressure, high cholesterol, smoking, diabetes and obesity are all factors that can be changed to lower stroke risk.

And don’t forget exercise. “Regular exercise has been shown, time and time again, to drop stroke risk,” he says.

The good news

Awareness about stroke and treatment might be paying off. Patients who have a stroke are doing better than in the past, says Dr. Moon. “And what’s really exciting is that mortality from stroke has gone down significantly. It used to be the No. 3 leading cause of death in the United States, and now it’s No. 5. That’s why it’s so crucial to get help early.”

(This story originally appeared in OC Catholic, July, 2015) 

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.


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