Provider Quality

Stroke is a major global health challenge. It ranks as the second-leading cause of death and the third-leading cause of disability worldwide. Factors such as high blood pressure, heart disease, diabetes, smoking, unhealthy diets, physical inactivity, obesity, and excessive alcohol consumption can all increase the risk of stroke.

Understanding a stroke, recognizing the signs, and knowing the risk factors can help you to act quickly. So, what is a stroke, and what do you do if you or someone else is experiencing symptoms? A stroke occurs when the blood flow to a part of the brain is blocked or when a blood vessel in the brain bursts. Each minute without proper oxygen and blood flow results in millions of brain cells being lost. Swiftly and safely restoring blood flow to the brain is critical to saving as many brain cells as possible. Stroke treatments are most effective when administered early.

What Does a Stroke Feel Like?
The experience of having a stroke can differ greatly from person to person, but several common symptoms often serve as early warning signs. The sudden onset of these symptoms is critical to recognizing a stroke in its early stages, enabling you to seek immediate medical help. Here's an overview of symptoms that can indicate the onset of a stroke:

• Vision changes
• Numbness, weakness, or paralysis
• Severe headache
• Auditory changes
• Dizziness, loss of balance, or an unexplained fall

Take Action Now
Spend a few moments today learning the FAST method's signs of stroke and understanding what a stroke might feel like. The FAST Method is:

• Face drooping: Does one side of the face droop, or does the person report numbness on one side? Ask the person to smile. Is their smile uneven or lopsided?
• Arm weakness: Check if one arm is weak or numb. Have them raise both arms. Does one arm drift downward?
• Speech difficulties: Listen for slurred speech. Can they speak clearly and repeat a simple sentence like "The sky is blue"?
• Time to call 9-1-1: If you see any of these signs, act immediately and call 9-1-1, even if the symptoms go away. Remember when the first symptoms appeared and share these details with emergency services.

Quick detection and treatment can make all the difference in successful outcomes for people who have had a stroke. That’s why it’s important not to delay getting care.

Bridging the Gap
University of Rochester Medical Center and healthcare providers nationwide are pioneering stroke treatment solutions to bridge care gaps, recognizing the importance of quick action in successfully treating stroke. As part of URMC's comprehensive stroke care, Dr. Tarun Bhalla, an endovascular neurosurgeon, introduced a Mobile Stroke Unit (MSU) to Rochester in 2018, the first in the region. The MSU's launch is significant for Monroe County, as fast access to stroke care has historically been challenging, especially in rural areas. In situations where "time is brain," delivering care as quickly as possible is crucial.

Mobile Stroke Units like URMC's are designed to function as mobile emergency rooms, equipped with essential imaging technology, such as CT scanners that quickly provide detailed brain images, and staffed by a team of medical experts, including a CT technologist, a stroke-trained critical care nurse, an EMT, a paramedic, and a neurologist. Using the same symptom checks a patient would receive in a hospital's emergency department, the team evaluates the patient's condition to determine if they are eligible for time-sensitive treatments like IV thrombolytics—medications that dissolve blood clots—right on the MSU.

In stroke care, the 'golden hour' refers to the first 60 minutes after a person was last known to be stroke-free, or in other words, the last time before they first exhibited symptoms. Receiving treatment within this golden hour is linked to the best outcomes and the highest chances of a full recovery. However, due to delays in recognizing symptoms or transportation and diagnosis, emergency rooms can only begin treatment within that golden hour for two to three percent of patients. Because the MSU arrives directly at the patient's location and begins assessment immediately, it can provide faster stroke treatment, achieving initial treatment within the crucial 60-minute window in 30 to 33 percent of cases.

URMC also supports patients and medical staff at URMC-affiliated hospitals and regional partners through teleneurology, another advancement in stroke treatment. Teleneurology uses video conferencing and digital communication tools to perform remote neurological evaluations, making specialist care accessible from almost anywhere.

Through the Teleneurology initiative, URMC neurologists ensure that neurological needs are met beyond the emergency room, with 24/7 remote acute and inpatient neurological support. This round-the-clock support has enabled 16 hospitals across upstate New York to be recognized as Primary Stroke Centers. It allows patients to receive specialized care locally, minimizing the need to relocate to larger centers and keep care close to home. This approach has led to a 15 percent decrease in patients needing to be moved for treatment.

Stroke outcomes can vary significantly. Some people fully recover, while others may face lifelong challenges, including movement, speech, or vision difficulties. However, the best chance of recovery comes from receiving immediate medical attention. Sharing information on the signs and symptoms of stroke, we can ensure more people can spot a stroke and get help immediately.