The American Heart and Stroke Associations say to remember the signs of a stroke this way: F=face drooping, A=arm weakness, S=speech difficulty and T=time to call 911. Remembering FAST could make the difference between life and death or the difference between a full recovery and a permanent disability.
What is a Stroke?
There are three types of stroke:
1. Ischemic stroke occurs when a blood clot obstructs a blood vessel supplying blood to the brain and deprives the brain of blood flow. It is accounts for 87% of stroke cases.
2. Intracranial hemorrhage occurs when a weakened blood vessel ruptures, usually due to high blood pressure. The mass of blood from the ruptured artery pushes on the normal brain, reducing its blood flow and can directly damage the brain.
3. Subarachnoid Hemorrhage is a type of hemorrhagic stroke in which a weakness in the wall of a blood vessel dilates and bursts. These weakened blood vessels are called aneurysms and arteriovenous malformations or AVMs. Intracranial and subarachnoid hemorrhage account for about 13% of stroke cases.
4. A Transient Ischemic Attack (TIA) is often referred to as a “mini-stroke” and is caused by a temporary clot that prevents blood flow to the brain. They can be a predictor of a more serious stroke to occur in the future.
How is a Stroke Treated?
The good news is that most strokes can be treated if bystanders recognize the symptoms and react quickly to get the stroke victim to the emergency room. Richard Fessler, M.D., neurosurgeon at Michigan Head & Spine Institute, knows the importance for patients to seek treatment from stroke experts – quickly.
Dr. Fessler developed several statewide programs to provide state-of-the-art point of access care to stroke and aneurysm patients using tele-medicine. Doctors in areas where stroke specialists are not on-site use the tools of the Stroke Network to connect with stroke experts as they treat patients in their emergency rooms. This provides the patient with the best possible outcome.
Dr. Fessler, director and originator of the Ascension of Michigan Stroke Network and the Trinity Michigan Stroke Network, explains “the goal of treating a stroke is to restore blood flow to the brain as quickly as possible to prevent damage to the brain. For an Ischemic stroke that treatment might include tissue plasminogen activator (tPA).”
tPA is a clot busting drug which must be given within 3 to 4.5 hours from the first signs of a stroke. If the drug does not reduce the clots, minimally invasive surgery is required to remove the clots. This is generally performed by a neurosurgeon, like Dr. Fessler, who is a neuroendovascular specialist. Dr. Fessler removes clots or repairs ruptures from a stroke by guiding a catheter through a major artery to remove the clot or repair the aneurysm or AVM. These endovascular procedures are minimally invasive and often the patient is home anywhere from the same day to two days later. “Surgical options for stroke and aneurysms have significantly advanced in the last decade. The critical factor is seeking treatment immediately. It’s important everyone knows what to look for and then reacts quickly,” explains Dr. Fessler
Rehabilitation After A Stroke
Patients who do suffer a stroke can require physical rehabilitation. At Michigan Head & Spine Institute, physiatrists – physical medicine and rehabilitation doctors have the expertise to work with stroke patients to return each person to being able to function to the fullest extent possible.
Dr. Fessler often sees stroke patients in the emergency room during a stroke. He also treats patients for other neurosurgical conditions, including diagnosis and treatment of unruptured aneurysms. For those who require rehabilitation, a consult with an MHSI physiatrist for stroke rehabilitation can be scheduled by calling 248-784-3667.
