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Stroke 

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Stroke is the third leading cause of death in the United States, and the leading cause of adult disability. When you or one of your loved one’s life is in jeopardy because of a stroke, you need the best and you need them to have the same sense of urgency you do.

If you suspect you or a loved one is suffering from a stroke, dial 911 immediately.

A stroke can happen when vital blood flow and oxygen is cut off from your brain. Two million brain cells die every minute during stroke, which increases the risk of permanent brain damage, disability or death.

What happens in the first few hours after a stroke saves lives.

Tests

Your neurologist will perform a physical examination to determine if you’ve had a stroke.

Computed Tomography Scan (CT or CAT Scan)
This is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays and are used to detect abnormalities and help identify the location or type of stroke.

Magnetic Resonance Imaging (MRI)
This is a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. An MRI uses magnetic fields to detect small changes in brain tissue that helps to locate and diagnose stroke.

Radionuclide Angiography
This is a nuclear brain scan in which radioactive compounds are injected into a vein in the arm, and a machine creates a map showing their uptake into different parts of your head. The images show how your brain functions rather than its structure. This test can often detect areas of decreased blood flow and tissue damage.

Computed Tomographic Angiography (CTA) 
A CTA is an X-ray that uses CT technology to obtain images of blood vessels

Magnetic Resonance Angiography (MRA) 
An MRA is a procedure used to evaluate blood flow through arteries in a noninvasive (the skin is not pierced) manner using MRI technology.

Functional Magnetic Resonance Imaging (fMRI)
An fMRI is a variation of an MRI used to determine the specific location of the brain where a certain function, such as speech or memory, occurs.

Electroencephalogram (EEG)
An EEG is a procedure that records the brain’s continuous, electrical activity by means of electrodes attached to the scalp.

Carotid Phonoangiography
In this procedure, a small microphone is placed over the carotid artery on your neck to record sounds created by blood flow as it passes through a partially blocked artery. The abnormal sound is called a bruit.

Doppler Sonography
In this procedure, a special transducer is used to direct sound waves into a blood vessel to evaluate blood flow. An audio receiver amplifies the sound of the blood moving though the vessel. Faintness or absence of sound may indicate a problem with blood flow.

Ocular Plethysmography
This measures pressure on the eyes, or detects pulses in the eyes.

Cerebral Blood Flow Test (Inhalation Method)
This measures the amount of oxygen in the blood supply that reaches different areas of the brain.

Digital Subtraction Angiography (DSA)
A DSA provides an image of the blood vessels in the brain to detect a problem with blood flow. The test involves inserting a small, thin tube (catheter) into an artery in the leg and passing it up to the blood vessels in the brain. A contrast dye is injected through the catheter and x-ray images are taken.

Treatments

Early treatment can help minimize damage to your brain tissue and improve your outcome. Treatment depends on the type of stroke and on the underlying cause of the condition. An ischemic stroke is the most common type of stroke. It occurs in an obstructed blood vessel leading to the brain. A hemorrhagic stroke occurs when a weakened blood vessel ruptures. The long-term goals of treatment include rehabilitation and prevention of additional strokes.

Medication
Treatment for ischemic stroke involves removing the blockage and restoring blood flow. Tissue plasminogen activator (t-PA) is a medication that can break up blood clots and restore blood flow when administered within 3 hours of the event. A diuretic, may also be administered intravenously to reduce intracranial pressure during an ischemic stroke.

Antihypertensives
These may be used alone or in combination with diuretics to treat high blood pressure. Antiplatelet agents may be prescribed to reduce the risk for recurrent stroke. Antiplatelet medication that is taken orally, once a day, to help prevent the formation of blood clots is prescribed for patients with atherosclerosis who have had a recent stroke and can be used to prevent recurrence.

Surgery
Surgery will relieve intracranial (within the skull) pressure caused by bleeding. Most of the damage caused by this type of stroke results from the physical disruption of brain tissue.

Surgical treatment for hemorrhagic stroke caused by an aneurysm or defective blood vessel can prevent additional strokes. Surgery may be performed to seal off the defective blood vessel and redirect blood flow to other vessels that supply blood to the same region of the brain.

Endovascular Treatment
This procedure involves inserting a long, thin, flexible tube (catheter) into a major artery, usually in the thigh, guiding it to the aneurysm or the defective blood vessel, and inserting tiny platinum coils (called stents) into the blood vessel through the catheter. Stents support the blood vessel to prevent further damage and additional strokes.

Why Choose UHealth?

A collaborative environment. We see more than 41,000 clinic visits each year. Our team provides world-class care at various locations throughout Miami-Dade, Broward and Palm Beach counties, including the Joint Commission-accredited Primary Stroke Center at UHealth Tower and Jackson South and the Comprehensive Stroke Center at Jackson Memorial Hospital.

Outpatient services. Our stroke neurologists also see patients at the UHealth Neurology Outpatient Clinic and our Neurovascular Laboratory, an IAC-certified facility. We offer state-of-the-art noninvasive diagnostic options such as:

  • Extra-cranial duplex
  • Transcranial doppler
  • Emboli detection studies
  • Vasomotor reactivity evaluation
  • Noninvasive right to left shunt detection

One of 25 regional stroke centers for the NINDS Stroke Trials Network. The Stroke Division physicians conduct cutting edge research to address a variety of cerebrovascular diseases. We are actively enrolling patients in acute stroke treatment, stroke prevention, and stroke recovery trials, and have special interest in stroke in minorities. 

Certified vascular treatment.  Almost 2,400 procedures are performed and interpreted annually by the experts at the Patrick Cesarano Neurovascular Laboratory, located in the Professional Arts Building, and certified by the Intersocietal Commission for Accreditation of Vascular Laboratories (ICAVL). It performs outpatient extracranial studies and ambulatory and inpatient intracranial studies including transcranial doppler, microemboli detection, vasomotor reactivity, and right-to-left shunt detection studies.

One of the largest neuroscience ICU’s in the country. You have access to advanced stroke-related procedures, including endovascular thrombectomy, aneurysmal clipping and coiling, and decompressive craniectomies, among others. We offer an 8-bed stroke unit, a step-down neurosurgical unit, and 2 bi-plane neuro-interventional suites. This site offers expanded monitoring capabilities including microdialysis and all beds in the Neuro-ICU and the Stroke Unit are EEG-wired.  

Inpatient stroke service. A 24-7 stroke team responds immediately to all acute cerebrovascular events to initiate acute therapy. We have extensive experience in thrombolytic therapy. Through our close collaboration with our neuro-interventional team, we can offer endovascular acute therapy including mechanical and chemical thrombolysis. In addition, we can offer hypothermia to cardiac arrest victims. 

Collaborative neurology teams. We work hand-in-hand with other neurology and neurosurgery teams, including Neurocritical Care, Interventional Neurology, Vascular Neurosurgery and the Cerebrovascular Diseases Research Laboratories.


StrokeAware: Get Informed About Strokes

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Stroke is the third leading cause of death in the U.S. and the leading cause of serious, long-term, adult disability. Each year, over 700,000 people have a stroke; 75% of these are first attacks. Knowing the warning signs and acting quickly are our best defenses against Stroke.


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