Many of our member facilities have various events planned throughout May to educate their staff and the local community about National Stroke Awareness Month. Nearly 800,000 strokes are reported annually here in the United States, almost one every 40 seconds. It’s no secret that strokes affect the young and the old as well as males and females. Stroke continues to rank number three in the leading causes of death among Americans.
As an imaging analyst here at MD Buyline, I wanted to take the opportunity to highlight some of the advances in technology and imaging procedures/protocols in today’s market that have made a substantial impact on stroke and stroke-related detection and treatments.
After doing some research on the history of stroke, I found that Hippocrates and the Greeks acknowledged strokes as apoplexy (“striking or hitting away”). Eventually stroke and cerebral vascular accident (CVA) have become the standard dialogue, along with the term brain attack, which does a great job of differentiating heart attacks from strokes by emphasizing the actual anatomy affected within the terminology utilized.
Carotid artery disease, a huge risk factor for strokes, can often be detected through ultrasound imaging, CT scan, and MRI. Acute stroke management is now associated with the golden “3 hour-rule” where tPA (tissue plasminogen activator) has been proven to effectively minimize some of the long-term effects of a stroke if administered within three hours of the onset of symptoms. Clearance for giving tPA is typically contingent upon a stat non-Contrast CT scan, lab work, Chest X-ray, EKG, and Carotid Doppler Ultrasound. Having dedicated CT scanners within hospital emergency departments has been extremely instrumental in reducing imaging wait times. In addition, computed tomography units continue to get faster and faster in a technological sense. Naturally, the fact that today’s CT scanners are much faster than those of previous generations helps in the race against time during acute stroke diagnosis and treatment.
Radiologist interpretation times have also dramatically decreased by way of PACS and Teleradiology. Today, neurosurgeons, cardiologists, and other physicians can view patient’s images on their iPads and other mobile devices to expedite timely care and treatments. Magnetic Resonance Diffusion has gained popularity in stroke diagnosis and treatment, as well as Transcranial Doppler exams in the evaluation of damaged blood vessels in the brain. Advances in technology have brought us higher MRI system field strengths (1.5T-3.0T), allowing for higher image quality and offerings in CT system software, such as CT Perfusion. Perfusion studies via CT provide a more rapid, extremely detailed look into brain vessels prior to thrombolytic therapy. Perfusion studies are highly regarded, as CT scanners are generally less expensive than MRI systems and the study itself is considered faster and less invasive than traditional angiography. Additionally, MD Buyline has seen a consistent trend over the past several quarters where the majority of new CT systems are being configured by hospitals and institutions nationwide to include the optional CT Perfusion software package.
Stroke Awareness Month hits close to home for me. During Thanksgiving weekend 2001, I witnessed my own mother having a severe stroke that forever changed her life. During what was a typical family restaurant outing, my mom began to exhibit the classic symptoms of “the worst headache ever” – imbalance, gait disturbance, and possessing little to no awareness of her surroundings at the moment. After several requests from her for more Advil, I mentioned to other family members with us that she may be having a stroke and we needed to get her to an Emergency Room quickly. At that time, I was actually a CT scan supervisor, so one can imagine the look on my face as a seasoned imaging professional, when the ER physician shared the stroke-evident CT images with me and my family after the exam. But, thanks to efficient staff, emergency imaging exam protocols, and speedy Radiologist interpretations, my mother was aboard a Careflight helicopter within 90 minutes and en route to a larger facility with a neurosurgeon standing by for treatment. She survived the stroke and completed a rigorous rehabilitation program, and I am happy to report that she now has only minor limitations to her daily activities.
Today, with assertive campaigns from organizations, such as the National Stroke Association, the Brain Attack Coalition, and the American Heart Association, coupled with the implementation of dedicated Stroke Centers at facilities specifically accredited by the Joint Commission’s Primary Stroke Center Certification Program, we are better armed in the fight against strokes.
If you have any questions on the imaging technology discussed in this blog or about stroke awareness, drop me a line. I’d also love to hear what type of activities are planned at your facility for National Stroke Awareness Month and ways that you have been able to engage others in the education of the risk factors, treatment, and prevention of strokes. Please feel free to contact me at Lori.Webb@www.mdbuyline.com.