cordina011.JPGA recent study that has been accepted for publication in the New England Journal of Medicine validates the use of endovascular intervention to treat patients who suffer from stroke or “brain attacks.”

This study, dubbed MR-CLEAN, proves that endovascular intervention in stroke patients is not only a life-saving procedure, but is also associated with a reduction in long-term disability. MR-CLEAN was presented at the World Stroke Congress in Istanbul, Turkey, in October. Since then, two other trials (ESCAPE and EXTEND-IA) have also been stopped early due to clear benefit in the endovascular group as compared to standard medical management.

The University of South Alabama Medical Center is the premier hospital in our region that was the first to introduce this latest gold standard technology in endovascular stroke treatment.

According to Dr. Steve M. Cordina, associate professor of neurology at the USA College of Medicine and medical director of the USA Stroke Center, a stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. Within minutes, brain cells begin to die. Dr. Cordina said the recent research is on the cutting edge of science, and will eventually change the care of stroke patients worldwide.

Endovascular stroke treatment involves the patient being taken to a neuro-catheterization suite where specialized endovascular neurologists insert a small hollow tube in the patient’s leg and route this tube to the brain. Once there, medication and tiny devices like retrievable stents can be used to restore blood flow to the brain.

Patients may be eligible to undergo endovascular treatment of an ischemic stroke “blockage” – the most common type of stroke. If given within four and a half hours of the start of symptoms, a clot-busting drug called tissue plasminogen activator (tPA) can reduce long-term disability. The medication allows blood and oxygen to once again flow to the brain.

Endovascular treatment then allows the treating physician to open up blocked arteries in cases when the tPA does not manage to do so, which is up to 50 percent of the time. It also allows treatment of patients who are unable to receive the medication, extending the treatment time window to up to eight hours or more after symptoms begin.

Dr. Cordina said stroke is the fourth leading cause of death in the United States and the leading cause of serious, long-term disability. On average, someone in the United States has a stroke every 40 seconds. He urges everyone to learn the warning signs and call 9-1-1 at the first sign of stroke. Many Gulf Coast residents are considered at risk for both “brain attacks” and heart attacks, because of high rates of diabetes, high blood pressure and high-cholesterol. Alabama is part of the so-called “Stroke Belt,” where there is the highest incidence of strokes in the country.

“Every minute, millions of neurons die in stroke patients,” he said. “Time is brain. The faster you get to the hospital, the higher are your chances of recovery.” It is therefore critical to receive treatment as soon as possible after the symptoms are noticed.

What are the stroke warning signs?
•    sudden weakness or numbness of the face, arm or leg, especially on one side of the body
•    sudden confusion
•    trouble speaking or understanding
•    sudden trouble seeing in one or both eyes
•    sudden trouble walking
•    dizziness, loss of balance or coordination
•    sudden, severe headache with no known cause

How do I know to call 9-1-1?
Use the FAST test (facial, arm, speech, time test)
•    Facial - Look for facial droop. Normally, both sides of the face should move equally. It is abnormal for one side of the face to not move at all.
•    Arm weakness – Ask the person to raise both arms. It is abnormal for one arm to drift downward.
•    Speech – Look for abnormal speech. If they are unable to speak or understand, it could be a stroke. Ask the person to repeat a sentence.
•    Time – If you observe any of these signs, call 9-1-1 immediately.

To make an appointment with any USA Physician, call 434-3711.

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