Stroke Unit
A stroke causes brain damage due to either a disruption in blood flow to a specific area (ischemic stroke) or a hemorrhage caused by the rupture of a blood vessel (hemorrhagic stroke).
Specifically, ischemic stroke results from the blockage of brain arteries, either by a clot forming in a narrowed artery (thrombosis) or by a clot that formed elsewhere in the body and traveled to the brain arteries through the bloodstream (embolism). The type, severity, and recovery of symptoms depend on the size of the affected area and the timing of its revascularization.
Hemorrhagic stroke may be caused by the rupture of an aneurysm or arteriovenous malformation in the brain, or by the rupture of small vessels causing intracerebral or subarachnoid hemorrhage.
A patient suspected of having a stroke is rapidly assessed upon arrival at the Emergency Department. Nurses with extensive experience in emergency cases attend to the patient and activate the Stroke Medical Team. A neurologist performs an immediate clinical evaluation, and in collaboration with experienced radiologists, the extent and nature of the brain damage are determined using CT and/or MRI scans.
The treatment goal for ischemic stroke is to dissolve or remove the clot that obstructs the cerebral artery and restore normal blood flow to the brain.
Within 4.5 hours of symptom onset, intravenous administration of a thrombolytic drug (Actilyse r-tPA) can be administered, which, under specific conditions, dissolves the clot and restores normal brain circulation.
Within 24 hours of symptom onset, mechanical thrombectomy may be performed under certain conditions to open the blocked artery. This method is used in combination with intravenous thrombolysis within the first 4.5 hours of symptom onset in patients with severe strokes (NIHSS>6) caused by large vessel occlusion, and as the sole treatment when there are contraindications for thrombolytic administration or delayed arrival. Thrombectomy is the latest therapeutic advancement for treating severe strokes, with a success rate of 70-80% in opening the blocked artery.
The prompt recognition of stroke symptoms and the immediate arrival of the patient at the hospital plays a critical role in the treatment outcome. However, World Health Organization data shows that 70% of stroke patients are unable to recognize their symptoms.
Modified Cincinnati Stroke Scale for recognizing potential stroke:
Arms
Ask the patient to raise both arms with palms facing up and eyes closed.
NORMAL: Both arms move the same or not at all.
ABNORMAL: One arm is weaker and falls.
Face
Ask the patient to smile.
NORMAL: Both sides of the face move equally.
ABNORMAL: One side moves less or not at all, and the mouth appears “crooked.”
Speech
Ask the patient to repeat a sentence, such as: “I came home from work.”
NORMAL: Repeats correctly without slurring.
ABNORMAL: Does not repeat correctly, slurs words, uses wrong words/sounds, or does not speak at all.
Immediate Action
If any of the above signs are abnormal, do not delay. Contact the hospital’s Emergency Department immediately, which has a specialized Stroke Unit.
A stroke is a medical emergency that requires immediate attention and depends on the timely arrival of the patient at the hospital.
Time is brain
The treatment of a stroke within 3-4 hours of symptom onset is crucial for the effectiveness of the therapy and for minimizing complications. The expression commonly used in English medical literature is “time is brain,” emphasizing the very narrow window of time for saving brain tissue. It is estimated that approximately 2 million neurons are lost every minute that treatment for the blockage is delayed.
At the Stroke Unit of the Mediterranean Hospital, the latest international guidelines are followed, and the most modern therapeutic methods are applied to maximize clinical benefit for the patient. Additionally, the fully equipped Intensive Care Units (ICUs) and High Dependency Units (HDUs) ensure enhanced medical and nursing monitoring and care.
The seamless collaboration of the multidisciplinary team, comprising highly trained and experienced specialists from various fields (neurologists, neurosurgeons, interventional radiologists, vascular surgeons, interventional cardiologists, intensivists, anesthesiologists), guarantees the most comprehensive treatment for patients with cerebrovascular diseases. Our team is on standby 24 hours a day, every day, to provide the best possible care for each patient with a stroke.
We focus on providing excellent care for our patients.