Hendrick Health System - Hendrick Stroke Program

What is stroke?

Types of Stroke

Warning Signs of Stroke

How Stroke is Diagnosed

Risk Factors

Rehabilitation Following Stroke

Stroke Statistics

Contact Information

Resources

The Hendrick Stroke Program is composed of a multidisciplinary team of experts, including neurologists, neurosurgeons, emergency medicine, internists, cardiologists, rehabilitative specialists and a nursing staff specializing in stroke. Our experts are ready to respond anytime, day or night.
The most important factor is to seek immediate medical care. Once stroke occurs, the goal is to lessen the potentially debilitating effects, prevent further damage to the brain and reduce the medical and physical complications following a stroke.
The team provides treatment during the critical acute state of stroke - the first few hours after the onset of symptoms.

What is a Stroke?
A stroke is a sudden interruption in the blood supply of the brain. Most strokes are caused by an abrupt blockage of arteries leading to the brain (ischemic stroke). Other strokes are caused by bleeding into brain tissue when a blood vessel bursts (hemorrhagic stroke). Strokes are often referred to as a brain attack because theyoccur rapidly and require immediate medical treatment.

Blood is carried to the brain via a complex network of arteries and vessels. A stroke occurs when one of these arteries becomes blocked or an artery ruptures.

The effects of a stroke depend on which part of the brain is injured, and how severely it is injured. Strokes may cause sudden weakness, loss of sensation or difficulty with speaking, seeing or walking. Since different parts of the brain control different areas and functions, it is usually the area immediately surrounding the stroke that is affected.

Types of Stroke
There are several types of stroke, and each type has different causes. The three main types of stroke are listed below.

Ischemic Stroke
The most common type of stroke -- accounting for almost 80 percent of all strokes -- is caused by a clot or other blockage within an artery leading to the brain. Ischemic stroke can be caused by several different kinds of diseases. If the arteries become too narrow, blood cells may collect and form blood clots. These blood clots can block the artery where they are formed (thrombosis), or can dislodge and become trapped in arteries closer to the brain (embolism). Another cause of stroke is blood clots in the heart, which can occur as a result of irregular heartbeat (for example, atrial fibrillation), heart attack, or abnormalities of the heart valves. While these are the most common causes of ischemic stroke, there are many other possible causes. Examples include use of street drugs, traumatic injury to the blood vessels of the neck or disorders of blood clotting.

Intracerebral Hemorrhage
An intracerebral hemorrhage is a type of stroke caused by the sudden rupture of an artery within the brain. Blood is then released into the brain, compressing brain structures. The most common cause of intracerebral hemorrhage is high blood pressure (hypertension). Since high blood pressure by itself often causes no symptoms, many people with intracranial hemorrhage are not aware that they have high blood pressure, or that it needs to be treated. Less common causes of intracerebral hemorrhage include trauma, infections, tumors, blood clotting deficiencies and abnormalities in blood vessels.

Subarachnoid Hemorrhage
A subarachnoid hemorrhage is also a type of stroke caused by the sudden rupture of an artery. A subarachnoid hemorrhage differs from an intracerebral hemorrhage in that the location of the rupture leads to blood filling the space surrounding the brain rather than inside of it. Subarachnoid hemorrhage is most often caused by abnormalities of the arteries at the base of the brain, called cerebral aneurysms. These are small areas of rounded or irregular swellings in the arteries. Where the swelling is most severe, the blood vessel wall become weak and prone to rupture.

It is very important to recognize the warning signs of stroke and to seek immediate medical attention.

If you or someone you know is having these signs, call 9-1-1 and seek medical help immediately. Treatment is available, but only if a stroke is recognized in time. Do not wait to see if the symptoms go away. Even if the symptoms pass quickly, they could be an important warning that requires prompt medical attention.

Emergency Treatment of Stroke
Much of the damage caused by a thrombotic or embolic stroke occurs in the first few hours. The primary areas of research have focused on the development of new clot-dissolving drugs and medications that make the brain more resistant to stroke (neuroprotective agents).

Drugs that dissolve clots are known as thrombolytic agents. Clinical studies suggest that if given within the first few hours after stroke onset, these drugs may dramatically minimize stroke damage.

Thrombolytic Agents (tissue plasminogen activator [tPA]), widely used to dissolve clots that cause heart attacks, are also effective for dissolving artery-blocking clots in the brain during the critical early stages of stroke. Early administration of tPA after a stroke can reduce neurological damage significantly.

If you have had a stroke, or have had stroke warning signs or risk factors, it is very important to seek medical attention immediately. Your doctor will work with you to find the cause of your problem and determine the best treatment.

The first step is to obtain a careful medical history. Your doctor or health care provider will ask questions about your situation.

Next, you will undergo a thorough physical examination. Your doctor will check your pulse and blood pressure, and examine the rest of your body. The neurologic examination includes detailed tests of your muscles and nerves. The doctor will check your strength, sensation, coordination and reflexes. In addition, you will be asked questions to check your memory, speech and thinking.

Depending on the results of your evaluation, your doctor may need additional tests to fully understand your problem.

You may also be referred to a neurologist, neurosurgeon or another medical specialist. Sometimes it takes a while to discover the cause of stroke symptoms, and sometimes the cause of a stroke cannot be determined.

If you have ever had a stroke (or stroke warning signs), it is very important that you work with your doctor to determine the most likely cause of the problem and the best course of treatment for you.
Certain medical conditions greatly increase your likelihood of having a stroke or another stroke. Specific medical treatment can control some risk factors. They include:

Because of the tremendous advances in stroke treatment, along with the ever-increasing sophistication of rehabilitation techniques, the outlook for stroke patients has never been more hopeful.
The ultimate goal of rehabilitation is to return the patient to as independent a lifestyle as possible. Successful stroke rehabilitation is dependent on many factors, including the severity of brain damage and the cooperation of family and friends. Most stroke patients will benefit from some type of rehabilitation.

Stroke is the fourth leading cause of death in the United States. More than 143,579 people die each year from stroke in the United States.

Stroke is the leading cause of serious, long-term disability in the United States.

Each year, about 795,000 people suffer a stroke. About 600,000 of these are first attacks, and 185,000 are recurrent attacks.

Strokes can—and do—occur at any age. Approximately one quarter of strokes occur in people under the age of 65.

Stroke death rates are higher for African Americans than for whites, even at younger ages.

Dr. Alexander Landfield
Medical Director for the Hendrick Stroke Program
325-670-6190

Mavic Yoes, RN
Stroke Program Coordinator, Hendrick Medical Center
1900 Pine St.
Abilene, Texas 79601
325-670-6894 myoes@ehendrick.org.

Neurosurgeons
Dr. Steven Brown
1850 Hickory St., Ste. 101
Abilene, Texas 79601
325-670-4730

Dr. Talmadge Trammell
1850 Hickory St., Ste. 101
Abilene, Texas 79601
325-670-4730