Stroke care

A stroke happens when blood and oxygen flow to the brain is stopped or interrupted due to either a blockage in a blood vessel or a ruptured blood vessel. This loss of oxygen will cause damage to the brain. The two major kinds of stroke are ischemic stroke and hemorrhagic stroke.

Ischemic stroke

Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot, preventing oxygen from reaching brain cells. This is the most common kind of stroke. Causes for ischemic stroke, include:

• atherosclerosis
• cardioembolism
• small vessel disease 

Transient ischemic attack

About 10 percent of people have a warning sign before an ischemic stroke. This is called a transient ischemic attack (TIA).

A TIA is a temporary interruption of blood flow to a part of the brain. The signs and symptoms of a TIA are the same as those experienced with a stroke, but they last for a shorter period (usually less than one hour) and then disappear, without leaving permanent effects.

Because TIAs are temporary and the symptoms may resolve quickly, it is easy to ignore them or to believe that the problem has disappeared. It is dangerous to ignore TIAs, however, because the underlying problem that caused the TIA continues to exist. It is extremely important to understand that a TIA requires immediate medical attention as they are often early warning signs of a more serious and debilitating stroke to come.

Hemorrhagic stroke

A hemorrhagic stroke occurs when a brain blood vessel bursts and bleeds, causing blood to leak into or around brain tissue. As it collects, the pool of blood puts pressure on the brain and irritates brain tissue.

The two different types of hemorrhagic stroke are:

• intracerebral hemorrhage
• subarachnoid hemorrhage

Through prevention, education, treatment and rehabilitation, Allina Health is working to lower the incidence and improve the recovery from all types of stroke.

Stoke symptoms

• severe headache with no known cause
• sudden confusion or trouble speaking or understanding speech
• sudden difficulty walking or dizziness, loss of balance or problems with coordination
• sudden numbness or weakness in the face, arm or leg (especially on one side of the body)
• sudden vision problems in one or both eyes

Certain risk factors increase your chance of having a stroke, many of which can be controlled for. 

• alcohol use 
• atrial fibrillation (irregular heart beat)
• carotid artery disease
• diabetes
• diet high in fat, cholesterol and sodium
• family history of stroke
• heart disease 
• high blood pressure 
• high cholesterol
• overweight
• peripheral artery disease (PAD)
• personal history of stroke or TIA
• physical inactivity
• tobacco use

All Allina Health hospitals have access to stroke neurology specialists either in person or via TeleStroke 24 hours a day/7 days a week.

Get help immediately

As soon as the symptoms of stroke begin, it is very important to call 911. The sooner someone experiencing stroke can get to an emergency department, the better their chances are to get treatment that can reverse the stroke process, limit potential injury or save their life.

At an Allina Health hospital, if someone experiencing stroke arrives in time for early treatment choices to have an impact, evaluation maybe expedited by something called a Stroke Code. This is a process that rapidly assembles a team of people to the bedside.

This team’s sole purpose is to quickly complete the initial evaluation so that time-sensitive treatment choices are given as quickly as possible (if appropriate). When a stroke is suspected, diagnosis is made by a neurologist who specializes in stoke. He or she reviews the patient’s symptoms, medical history, physical exam and test results. 

The initial physical and neurological examination includes:

• blood tests
• swallowing tests
• imaging tests
• heart tests

Initial treatment

Treatment differs depending on the type of stroke, and each type of stroke also has several treatment choices. Stroke treatment is individualized so that it best meets each patient’s particular medical needs.

Ischemic stroke

Early treatment for an ischemic stroke focuses on dissolving or removing the blood clot in a blood vessel or preventing further clot formation. Several types of treatment are available.

·       clot-dissolving treatment

o   Alteplase (clot dissolving treatment)

o   intra-arterial treatment

o   aspirin

·       mechanical thrombectomy

Hemorrhagic stroke

Early treatment for a hemorrhagic stroke focuses on limiting more bleeding and treating the effects of the blood collection in the brain.

·       Control blood pressure

·       Control abnormal clotting

·       Reduce pressure in the cranial cavity

·       Prevent more bleeding:

·       aneurysm clipping

·       coiling (aneurysm or AVM embolization)

·       surgical AVM removal

·       radiosurgery

Good to know

Allina Health is a recognized leader in stroke care, offering comprehensive services for stroke patients and their families throughout the Allina Health system. Capabilities encompass the full spectrum of neurovascular care, including fast, accurate diagnosis, access to the most advanced treatments available and extensive rehabilitation services. 

Every Allina Health hospital is recognized as stroke ready by the state of Minnesota. That means every hospital is prepared to evaluate, stabilize and provide life-saving emergency care to patients who exhibit symptoms of stroke. All sites have access to experienced stroke neurology specialists either in person or via TeleStroke 24 hours a day/7 days a week.

Certified Comprehensive stroke centers

Abbott Northwestern and United hospitals have been awarded certification as Comprehensive Stroke Centers. Certification as a Comprehensive Stoke Center is recognition that the hospital is able to offer the highest level of treatment and care available for stroke patients, including advanced neuro-interventional radiology, neurosurgery and neuro-critical care services.

Certified Primary stroke centers

Mercy Hospital - Mercy Campus and Mercy Hospital - Unity Campus are certified Primary Stroke Centers, demonstrating a focus on performance improvement and excellence in quality indicators for optimal stroke care.

Acute stroke-ready hospitals - certified by the Minnesota Department of Health

• Buffalo Hospital - Buffalo, Minnesota
• Cambridge Medical Center - Cambridge, Minnesota
• District One Hospital – Faribault, Minnesota
• New Ulm Medical Center - New Ulm, Minnesota
• Owatonna Hospital - Owatonna, Minnesota
• Regina Hospital - Hastings, Minnesota
• River Falls Area Hospital - River Falls, Wisconsin
• St. Francis Regional Medical Center - Shakopee, Minnesota