New technology allows doctors to reverse stroke damage hours later

12:00 a.m. Wednesday, Jan. 31, 2018 Lifestyle
St. David's HealthCare
Images from a CT profusion study using the RAPID software allows doctors to identify which areas of the brain have been most severely damaged by stroke (pink) and which contain salvageable brain tissue (green). A patient might be a candidate for thrombectomy, an emergency clot removal procedure, if there is a mismatch between the pink and green areas of the CT profusion scan results. St. David’s HealthCare

You might have heard that once a stroke happens, if you don’t get to the hospital and seek treatment within six hours, the damage is done. It is true that the sooner you get to the hospital, the better, but new studies and new technology are allowing doctors to treat the stroke six to 16 hours after it happens, with the possibility of up to 24 hours.

Advanced brain imaging using a RAPID CT Perfusion scan can see where the blood flow is being blocked and how much blockage there is. If it shows that the affected area of the brain is getting some blood flow, just not enough blood, “That’s a brain you can save,” says Dr. James Waldron, a neurosurgeon and medical director for endovascular neurosurgery at St. David’s Medical Center.

Then doctors can do a mechanical thrombectomy, which means they go in through the groin and thread a stent retriever to the area of the clot and retrieve the clot. Doctors are then able to reopen the area that was closed off or limited. This lessens the damage the stroke has caused or sometimes even reverses it.

“We get some miracle patients,” Waldron says, those who couldn’t speak or couldn’t walk who then afterward are able to walk out of the hospital. Most, though, are able to do some physical and occupational therapy to improve their condition.

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One study found that by doing the scan and then the thrombectomy, 45 percent of the patients were able to go home instead of 17 percent. They might still have some deficit left from the stroke, but they are able to take care of themselves.

The thrombectomy isn’t for every case, and this new technology is only good if patients recognize the signs of stroke and if the medical professionals treating them know to send them to a hospital with the imaging technology.

The signs of stroke are FAST:

Face: Ask them to smile and see if one side droops.

Arms: Ask them to lift both arms up and see if one floats down.

Speech: Ask them to say a simple phrase and see if it is slurred or strange.

Time: Call 9-1-1 and take them to a hospital with a stroke center.

While many of the people Waldron sees are older, he is seeing some younger patients. Many of them have diabetes, obesity or high blood pressure, smoke or have another pre-existing condition that puts them at risk.