Stroke is the leading cause of adult disability and the fourth-leading cause of death in the United States. After a person suffers a stroke, it’s critical that treatment start as soon as possible. For every hour’s delay in medical treatment, the brain loses 120 million cells. Typically, tissue plasminogen activator (tPA) is given at the onset of stroke to help dissolve clots blocking blood flow to the brain, but for strokes with large blockages, tPA may not always be effective. Now, stroke experts at UPMC are utilizing a groundbreaking treatment, called mechanical thrombectomy, to treat strokes with large blockages, and improve patient outcomes.
Here, you’ll learn about:
How tPA is used to treat stroke
Why mechanical thrombectomy is used to treat strokes with large blockages
How mechanical thrombectomy works
To learn more about strokes, contact the UPMC Stroke Institute to schedule an appointment or ask a question at 412-232-8840.
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string(5334) "The myths about strokes are numerous. Among the most popular — and perhaps one of the most dangerous — is that strokes are something that happens only to older adults.
In fact, a recent report by the American Stroke Association showed a sharp rise in hospitalizations among men and women ages 15 to 44, while rates declined by 25 percent among older adults.
Lowering your risk is the best way to avoid the life-changing impact strokes can have on you and your family. When strokes occur, fast action is critical to minimize damage. The window of opportunity for the most successful treatment is just three hours after onset.
Prevention: What You Can Do
Heart disease increases the chance of having a stroke. Because of this, it is important to live a healthy lifestyle and reduce the risks of heart disease.
While you can’t do anything about certain risk factors like age, family history, or ethnicity (Black Americans have a higher incidence of stroke), you can control high blood pressure, high cholesterol, obesity, physical inactivity, and smoking.
Since high blood pressure and high cholesterol increase the risk of stroke, maintaining a healthy lifestyle to keep both low is important. Preventing a stroke is far better and easier than dealing with the consequences.
Treatment: Time Lost is Brain Lost
Every minute after the start of a stroke means greater risk of permanent damage or death. One of the best treatments for ischemic strokes — where a clot blocks blood flow to the brain — is the quick administration of the clot-busting drug called tissue plasminogen activator (t-PA). While UPMC doctors have had success beyond three hours with a special procedure to retrieve the blockage or dissolve it with drugs administered directly into the clot, time is critical.
For patients experiencing hemorrhagic strokes caused by bleeding in the brain, fast action is needed to repair the leaking blood vessel.
Call 911
If you suspect someone has suffered a stroke, call for emergency medical help immediately so treatment can begin without delay.
Specialized stroke centers — such as UPMC's Stroke Institute at UPMC Presbyterian, UPMC Shadyside, UPMC St. Margaret, and UPMC Mercy — have experts available 24 hours a day, seven days a week to diagnose and treat patients. The UPMC Stroke Telemedicine Program also uses technology to provide fast treatment to patients at other UPMC hospitals throughout western Pennsylvania.
Think FAST
Use this simple acronym to help determine whether you're witnessing a stroke:
F ace: Can the person smile (or does one side of the face droop)?
A rms: Can the person raise both arms (or does one side drift downward)?
S peech: Can the person speak clearly or repeat a simple phrase?
T ime: Call 911 immediately if someone exhibits any of these warning signs!
Act FAST
Strokes require immediate medical attention, so knowing the warning signs is crucial, says William Kristan, MD, chairman of the Department of Emergency Medicine at UPMC Passavant. Stroke symptoms can include sudden onset of:
Paralysis or weakness in the face or limbs, especially on one side of the body
Problems with balance or walking
Vision problems
Slurred speech
Confusion
Problems speaking or understanding
Severe headache
For more information on stroke diagnosis and management, contact the UPMC Stroke Institute to schedule an appointment or ask a question at 412-232-8840."
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It’s a common misconception that only older adults suffer from strokes. In fact, a recent report by the American Stroke Association showed a sharp rise in hospitalizations among men and women ages 15 to 44, while rates declined by 25 percent among older adults. Read more to discover what you can do to prevent a stroke and what to do if you are faced with one.Read More
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string(5101) "Life after a stroke can be challenging, not to mention the added worry of having another. Each year in the U.S., an estimated one in four strokes will happen to someone who has already survived one, according to the National Stroke Foundation. You can reduce your risk of stroke by focusing on factors that you can control:
Diet
Exercise
Smoking
Managing medications
Managing other conditions
Eat a Healthy Plate
Diet is a great way to keep your body healthy and help prevent chronic disease. In addition to choosing more fruits and vegetables, lean meats, seafood, low-fat dairy, whole grains, and fiber, you should limit saturated and trans fats, sodium, alcohol, and added sugars. These choices can keep blood pressure and cholesterol levels lower, significantly reducing your risk of a second stroke.
Many stroke survivors have a limited appetite, or have trouble eating due to swallowing problems or limited arm movement. To help, you and your caregivers can create meals with stronger flavors and bold colors. Try adding salt-free herbs and spices to tempt your taste buds, and cut food into bite-sized pieces or choose softer foods that are easier to chew.
Stay Active and Quit Smoking
Stroke can limit your mobility, but even small amounts of activity can improve your overall health. Start with a low-impact activity that you enjoy. Chart your progress and take pride in each minute you're active. Even five minutes of walking or arm circles can help your physical health — and your mental health. Exercise can also build confidence, ward off depression and anxiety, and actually give you back energy.
Smoking is a major risk factor for future strokes, since it reduces the amount of oxygen in the blood. That in turn makes the heart work harder and makes blood clots more likely to form. Cigarette smoking also contributes to high blood pressure and respiratory illness. Although quitting is hard, smokers have double the risk of stroke as nonsmokers, so know the benefits and get help from family, coworkers, and your health care providers.
Keep an Eye on Related Conditions and Risks
Several health conditions and measurements have a direct impact on whether or not you have another stroke. High blood pressure can weaken arteries gradually, so keep it under control through lifestyle changes and medication. Likewise, high cholesterol should be managed carefully, and cholesterol-lowering statins are frequently prescribed.
You should also be checked for a type of irregular heartbeat called atrial fibrillation, which depending on its cause and severity can be treated in several ways. Though not as common as high blood pressure and cholesterol, atrial fibrillation is strongly associated with stroke. It causes blood to pool in the heart, which can form clots that travel to the brain.
Sleep apnea is common in survivors and associated with a much higher risk of another attack. Sleep apnea causes your airway to be blocked, which leads to lower blood oxygen, a faster heart rate, and higher blood pressure. Type 2 Diabetes, when not well controlled, can lead to serious cardiovascular problems, including stroke.
Manage Your Medications
Your doctors, pharmacists, and other providers have probably given you a laundry list of prescriptions along with when and how to take them. When added to all the other advice you've been given, this can be overwhelming, frustrating, and even insulting. Unfortunately, not taking medications as instructed — or noncompliance as it's called by health care providers — puts you at much greater risk of a recurrent stroke.
One cause of noncompliance with doctor's orders is denial. It's human nature to hope that by ignoring something, it goes away, and not taking medications can push away reality. While skipping one dose or one day's worth of a medicine may not make you feel any differently, the long-term effects can be dangerous. If you aren't sure about your dosage, or are frustrated by not seeing results, talk to your doctor before making changes on your own.
To learn more about strokes and the latest findings on their affects, contact the UPMC Stroke Institute to schedule an appointment or ask a question at 412-232-8840.
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string(293) "Each year, an estimated one in four strokes will happen to someone who has already survived one in the past. Thankfully, there are steps you can take to avoid falling into this statistic. Read more to discover four lifestyle choices that can help you reduce your risk of a stroke reoccurrence."
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Each year, an estimated one in four strokes will happen to someone who has already survived one in the past. Thankfully, there are steps you can take to avoid falling into this statistic. Read more to discover four lifestyle choices that can help you reduce your risk of a stroke reoccurrence.Read More
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string(4167) "If you know anyone who has suffered from a stroke, you might be aware of one of the more common treatments for stroke: the clot-busting drug called tPA. This treatment works by dissolving the blood clot and improving blood flow to the part of the brain being deprived of blood. While this has been the "gold standard" for stroke treatment for decades, a new treatment is proving more effective at removing large clots than tPA alone and can lead to better outcomes for stroke patients.
The method, known as mechanical thrombectomy with a stent retriever, was researched at UPMC and other facilities worldwide. In fact, the University of Pittsburgh School of Medicine, in partnership with the UPMC Stroke Institute, served as principal investigator in one clinical trial of stent retrieval thrombectomy and lead recruiter in another. Thanks to these trials' success, the procedure is now approved for widespread use throughout the world.
How the Mechanical Thrombectomy Procedure Works
When a stroke patient arrives for treatment, tPA is usually delivered directly to the site of the clot. After administering tPA, stroke physicians use advanced neuro-imaging to evaluate the patient's brain. If tPa alone does not dissolve the clot and restore blood flow, and the patient is a good candidate, mechanical thrombectomy is the next step.
During the mechanical thrombectomy:
A catheter is threaded into an artery in the groin and up through the neck, until it reaches the blood clot causing the stroke
Using x-ray guided imaging, a stent retriever is inserted into the catheter
The stent reaches past the clot, expands to stretch the walls of the artery so blood can flow, and is "retrieved" – or pulled backwards – which removes the clot
Benefits and Advantages of Mechanical Thrombectomy
Mechanical thrombectomy is considered a breakthrough in stroke treatment. Removing blood clots from the brain leads to better outcomes for stroke patients, including greater independence and mobility. Previous endovascular interventions were unable to remove clots quickly and safely enough. When used in conjunction with tPA and medical treatments, this method significantly reduces stroke-related disability and mortality.
To learn more about stroke prevention, treatment, and rehabilitation, contact the UPMC Stroke Institute to schedule an appointment or ask a question at 412-232-8840.
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While a clot-busting drug called tPA has been the main treatment option for stroke patients in the past decades, a new treatment option is proving more effective. The method, known as mechanical thrombectomy with a stent retriever, was researched at UPMC and other facilities worldwide and is now approved for widespread use. Read more to discover the benefits and advantages of the mechanical thrombectomy procedure.Read More
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string(5048) "Sometimes called a "brain attack," a stroke occurs when blood flow to the brain is interrupted, either when a blood clot blocks a vessel (ischemic stroke) or when a vessel weakens or bursts (hemorrhagic stroke). Brief interruptions in blood flow, known as transient ischemic attacks (also known as ministrokes), can mimic stroke symptoms.
When blood flow is interrupted, brain cells don't receive enough oxygen and begin to die. Depending on what part of the brain is damaged, a stroke can cause problems with:
Memory
Speech
Muscle control
Other functions
According to the National Stroke Association, an estimated 800,000 people experience a stroke every year. The problem is the leading cause of disability in American adults and the fifth leading cause of death in the country.
Act Immediately
Fortunately, ischemic strokes — the most common type of stroke — respond to immediate treatment with a drug called IV-tPA, which can dissolve blood clots that block blood flow to the brain. Research has shown that some patients who were treated with IV-tPA within three hours of developing stroke symptoms were at least 30 percent more likely to recover with little or no disability, compared to those who didn't receive this drug. Because IV-tPA must be administered as soon as possible, it's imperative that you seek immediate medical attention if you think you or a loved one is having a stroke.
Yet women are much less likely to receive this crucial treatment, possibly because they often experience different stroke symptoms than men. The latter tend to exhibit more "classic" symptoms. Here's the difference:
Classic Stroke Symptoms
Sudden numbness or weakness of the face, arm, or leg, particularly on one side of the body
Sudden confusion or difficulty speaking or understanding speech
Sudden difficulty walking, dizziness, or loss of balance or coordination
Although those are the symptoms that most people commonly experience, research has shown women are 33 percent less likely to report such "classic" stroke symptoms when they arrive at the emergency room than their male counterparts. Some people — and women in particular — are more apt to experience other, vague symptoms that could signal a stroke. These include:
Lightheadedness, fainting, or loss of consciousness
Difficulty breathing or shortness of breath
General weakness
Agitation
Confusion, unresponsiveness, or disorientation
Sudden behavioral changes
Hallucinations
Nausea or vomiting
Pain
Seizures
Hiccups
Because such symptoms are often associated with other problems, people who exhibit them may not be aware that they are experiencing a stroke. If you think that you or a loved one are having a stroke, call 911 immediately.
Contact the UPMC Stroke Institute to schedule an appointment or ask a question at 412-232-8840.
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Although symptoms like numbness or weakness in the face, arm, or leg on one side of the body, confusion, difficulty walking, or a severe headache are commonly reported stroke symptoms, research has shown women are 33 percent less likely to report such “classic” symptoms when they arrive at the emergency room than their male counterparts. Read more to discover how women experience stroke differently and the signs to watch for.Read More
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string(1320) "A stroke occurs when blood flow and oxygen to the brain is interrupted. This loss of blood and oxygen causes two million brain cells to die every minute, so time is of the essence. The longer a stroke goes untreated, the higher the odds of permanent brain damage, disability, or death. After suffering a stroke, you may experience a variety of symptoms. These depend on the side of the brain that the stroke occurs.
Check out our infographic to learn more about the symptoms of a stroke and the problems patients may face in the aftermath.
Stroke on the Right Side of the Brain
If the stroke occurs on the right side of the brain, you may experience:
Left-side weakness
Impulsive behavior
Overconfidence in abilities
Vision problems
Stroke on the Left Side of the Brain
If the stroke occurred on the left, you may experience:
Right-side weakness
Speech and language problems
Slow behavior
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string(142) "A stroke itself is a shock and recovery can be, too. Check out our infographic to learn some common issues faced in the aftermath of a stroke."
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Dealing with the aftermath of a stroke can be challenging. Depending on the severity, symptoms can vary from weakness to visual problems to speech and language issues. Patients may even need specialized therapy to address acute problems. Read more to discover the common issues faced in the aftermath of a stroke.View Infographic
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string(4097) "Heart attacks and stroke (also called "brain attacks") are quite different, but both can be life threatening. Identifying the symptoms as soon as possible in you or a loved one can help ensure immediate treatment, which in turn increases the chance of survival and lessens the likelihood of lasting damage and disability. Here's the difference between a heart attack and a stroke — and what to look for so you can get the appropriate care.
What Is a Heart Attack?
Also known as a myocardial infarction, a heart attack occurs when blood flow to the heart is reduced or interrupted, typically by clogged, narrowed arteries, or a blood clot. When blood flow is blocked, the heart muscle can't get enough oxygen and begins to die.
Heart attack risk factors
You're at higher risk for having a heart attack if you:
Pressure, squeezing, fullness, or pain in the center of the chest that lasts more than a few minutes or stops and recurs
Discomfort that extends to the shoulders, arms, back, abdomen, jaw, and teeth
Shortness of breath
Sweating
Lightheadedness or fainting
Heart attack symptoms in women
Women may experience different or more vague symptoms, such as:
Abdominal pain that may feel like heartburn or indigestion
Dizziness
Unusual fatigue
Clammy skin
What Is a Stroke?
A stroke occurs when blood flow to the brain is interrupted, either when a blood clot blocks a vessel (ischemic stroke) or when a vessel weakens or bursts (hemorrhagic stroke). Brief interruptions in blood flow, known as transient ischemic attacks (also known as ministrokes), can mimic stroke symptoms.
When blood flow is interrupted, brain cells don't receive enough oxygen and begin to die. Depending on what part of the brain is damaged, a stroke can cause problems with memory, speech, muscle control, or other functions.
Stroke symptoms
Classic stroke symptoms include:
Sudden numbness or weakness of the face, arm, or leg, particularly on one side of the body
Sudden confusion or difficulty speaking or understanding speech
Sudden difficulty walking, dizziness, or loss or balance or coordination
Sudden trouble seeing in one or both eyes
Sudden severe headache with no known cause
Stroke symptoms in women
Women may experience different or more vague symptoms, such as:
Lightheadedness, fainting, or loss of consciousness
If you think that you or a loved one are having a heart attack or stroke, call 911 immediately. To learn more about stroke rehab and stroke prevention, visit the UPMC Stroke Institute website.
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Heart attacks and strokes are different medical conditions, but both occur when blood flow is interrupted, to the heart and the brain, respectively. Identifying the symptoms as soon as possible can help ensure immediate treatment, which in turn increases the chance of survival and lessens the likelihood of lasting damage and disability. Read more to discover the difference between a heart attack and a stroke—and what to look for so you can get the appropriate care.Read More
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string(3626) "For many people, the threat of having a stroke is a feared part of getting older. But the truth is that a stroke (also called a "brain attack") can happen at any age. Stroke treatment depends on the type of stroke. There are two main types of strokes, but both occur when blood flow — and therefore the delivery of oxygen — to the brain is interrupted.
To learn more about stroke prevention, treatment, and rehabilitation, contact the UPMC Stroke Institute to schedule an appointment or ask a question at 412-232-8840
An ischemic stroke occurs when a blood clot blocks a blood vessel in or leading to the brain. Ischemic strokes are by far the most common type of stroke and make up and estimated 85 percent of all strokes. There are two subcategories of ischemic stroke: Thrombotic strokes occur when a blood clot blocks a vessel in the brain, while embolic strokes occur when a blood clot forms elsewhere in the body and moves to the brain.
The second main type of stroke is called a hemorrhagic stroke. It occurs when a blood vessel in the brain leaks or bursts. A third kind of stroke, a transient ischemic attack (TIA) or "ministroke" is a brief interruption in blood flow to the brain that can mimic stroke symptoms. In all three cases, when blood flow is interrupted, brain cells don't receive enough oxygen and begin to die. Depending on what part of the brain is damaged, a stroke can cause problems with memory, speech, muscle control, or other functions.
Treating Different Types of Strokes
As you might imagine, treatment depends on the type of stroke.
Ischemic stroke treatment
Doctors typically treat an ischemic stroke with medications that break up blood clots. These include aspirin, which is given immediately in the emergency room to help prevent another stroke from occurring. The intravenous drug IV-tPA can also dissolve blood clots and restore blood flow, and has been shown to help reduce stroke-related disability in some people. However, this treatment must be given within about four-and-a-half hours after the onset of symptoms. Intra-arterial tPA or mechanical thrombectomy — advanced treatments available at the UPMC Stroke Institute — can be administered to select patients within eight to ten hours after symptoms begin.
Hemorrhagic stroke treatment
Treatment for a hemorrhagic stroke usually involves medications to stop bleeding, lower blood pressure and reduce the risk of seizures. Once bleeding is controlled, your physician may recommend that you undergo surgery to repair blood vessel abnormalities to help prevent another stroke from occurring.
Transient Ischemic Attack (TIA) treatment
If you have had a ministroke or TIA, your doctor will take steps to help prevent another TIA or a full-blown stroke. Therapies can include medications that protect against blood clots, such as anti-platelet drugs (aspirin, Plavix) and anticoagulant drugs; or blood thinners (heparin, warfarin). Depending on your individual situation, your doctor may also recommend surgery or other procedures to clear clogged arteries.
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A stroke occurs when blood flow to the brain is interrupted, but many don’t realize there are two different types. As you might imagine, treatment very much depends on the kind you or a loved one suffers, whether ischemic or hemorrhagic. Read more to discover the treatment options for each type of stroke.Read More
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