Check Your Health: New guidelines for stroke treatment

(KUTV)- Stroke has dropped from fourth to fifth as the leading cause of death in the U.S. The American Stroke Association attributes the higher survival rates due to advances in medical treatment, specifically new guidelines that extend the time frame for life-saving treatment.

“This allows us to treat more people help more stroke patients recover faster,” said Dr. Megan Donohue at Intermountain Medical Center.

The 2018 guidelines from the American Heart Association and American Stroke Association recommends an increased treatment window for clot removal from six hours to 24 hours for qualifying patients. The guidelines also expand the eligibility for clot busting drugs for ischemic stroke patients. The expanded time frame allows physicians to help more patients lower their risk of disability from stroke.

The time limit for stroke treatment to remove blood clots used to be 4 1/2 hours for IV medication and 6 hours for what’s called intra-arterial therapy. But starting last year, the window for intra-arterial therapy was extended to 24 hours for select patients, who can benefit from a procedure called mechanical thrombectomy where a blood clot is mechanically removed.

“If you recognize the signs in yourself or a loved one, call 911 right away and get medical attention so that you're eligible for any treatment we have available,” said Dr. Donohue.

For some patients, blood clots are located through a CT angiogram. For treatment, a catheter (a thin tube threaded inside an artery) is sent up to the brain to deploy a device to pull out the blood clot. Once the clot is removed, the blood flow will return. If the stroke is allowed to progress, the patient could have permanent loss of language abilities, the use of his right side, or worse.

“Anyone can have a stroke. We have young people have strokes all the time. Strokes can be quite common about 800,000 strokes happen each year in the United States,” said Dr. Donohue.

Scott Pearson, 54, an avid outdoor enthusiast was skiing at Snowbird late this winter when he blacked out after getting off the ski lift. Scott had taken the tram in hopes of skiing down Mount Baldy, but wasn’t feeling well and decided to take an easier way down instead. Scott doesn’t remember what happened next, but a fellow skier from out of town spotted him slumped up against the snowbank and called for ski patrol.

“It was a little over two hours from Snowbird down to Intermountain. I had about two and a half three hours and I would have been completely brain dead. I got lucky. Snowbird got me down real fast and it was really stormy that day so they couldn’t helicopter me,” said Scott.

Within 16 minutes of arriving at Intermountain Medical Center, Scott had a CT Scan, where doctors discovered a 3-inch clot in the main artery and another 1-inch clot in the right side of his brain.

In 55 minutes, he began receiving EVT (Endovascular Thrombectomy) – a stroke treatment for patients with acute ischemic strokes that removes large stroke-causing clots from the brain.

“The doctor told me time was of essence in that he could go 98% brain dead if he didn't get that clot out within 15 minutes,” said Lorie Pearson, Scott’s wife.

Scott says he doesn’t remember anything until about a week later.

“The week that he doesn't remember he was in ICU for two days. That was really scary. He had his family coming up and just loving on him,” said Lorie.

Scott was then moved to the rehab center and started going through physical therapy. Within 23 days, Scott relearned to walk and talk. He is now waiting for his double vision to go away.

“I wake up every morning and look at the TV or the window and say no, not today maybe tomorrow,” said Scott.

Scott has already started riding his bike again. Earlier this summer, he went kayaking with his family. Scott’s goal is to get back on the ski slopes next winter.

“I’m trying to get back on the slopes because that was my passion,” said Scott.

What you need to know about strokes:

What happens when you have a stroke? There are two main types of stroke: ischemic stroke and hemorrhagic stroke. Both mean not enough blood and oxygen are getting to your brain. With an ischemic stroke, you may be eligible to receive a strong clot-busting medication, called TPA.

The most important thing to know is that “time is brain.” The more rapidly we’re able to recognize a stroke and provide interventions to restore blood flow, the more likely the patient is to have a positive outcome.

Is stroke common? Each year there are more than 795,000 strokes in the U.S. Every 40 seconds, someone has one, and every four minutes, someone dies from a stroke. If you’re having a stroke, your best chance at recovery is to have a fast response time. The sooner you get into the hospital and get the proper treatment the better off you’ll be for every minute of a stroke, two million brain cells die.

What increases the chances of a stroke? Strong risk factors of a stroke include heart disease, diabetes, high blood pressure, high cholesterol, and smoking. You should also know your family history and the type of stroke any family members have suffered.

Know the signs of stroke. About 40 percent of people in the United States can’t identify at least one of the symptoms. A good way to remember the signs of stroke is by using the acronym BE FAST.

B = Balance – sudden dizziness or loss of balance and coordination

E = Eyes – sudden trouble seeing in one or both eyes

F = Face – sudden weakness of the face (Does one side of the face droop?)

A = Arm – weakness of an arm or leg

S = Speech – sudden difficulty speaking

T = Time – time the symptoms started

If you think you're having a stroke: Call 911 immediately. If you have stroke-like symptoms but they go away, you may have had a transient ischemic attack (TIA) which is an indicatory that you are likely to have a full stroke in the near future. Do not ignore a TIA - head to the Emergency Department or call our outpatient neurologists right away.

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