Fast treatment and good care can make all the difference.
Joey Gee, DO, a neurologist at
Mission Heritage Medical Group in Mission Viejo, recently saw a patient who came to the ER with stroke
symptoms. “The individual was at home when she began having difficulty
talking and using one arm and leg,” he says. “She called 911
and an ambulance brought her to the hospital.” Determining that
she was suffering from an ischemic stroke, Dr. Gee administered tPA or
tissue plasminogen activator, an FDA-approved medication that breaks up
Luckily, this patient took exactly the right action by calling 911—it
meant she received treatment that halted the effect of the stroke on her
brain cells, and increased her chances of recovery. Although recovering
from a stroke depends on many factors, getting to the hospital as soon
as possible is high on that list.
Are you having a stroke?
“With an ischemic stroke, there is blockage of an artery and a portion
of brain is not receiving adequate blood—so cells start to die,”
explains Gee. “It doesn’t take a long time. Millions of cells
are at risk of cell death.” Yet the symptoms of an ischemic stroke
are sometimes painless, and thus easy to shrug off: “Changes in
facial appearance, weakness, paralysis, one side of body losing sensation
or impairment, the way eyes appear, slurred speech,” says Gee. “Without
pain or discomfort, many individuals may not react quickly. They’ll
think it will just go away or they just want to wait and see.”
Recognizing stroke symptoms is critical. The other kind of stroke, called
hemorrhagic, happens when blood begins to leak from a weakened artery
into the brain. Its hallmark symptom is a blindingly painful headache.
“With hemorrhagic stroke there is a greater risk of mortality,”
says Gee. Treatment includes stabilizing the patient’s vital signs
and possibly surgery to stop the bleeding.
Clearing the blockage
CAT and MRI imaging can help doctors assess the stroke and decide the next
step in treatment, such as removing a clot.
“Blockage that occurs in a large vessel may not cleared with tPA
alone,” explains Gee. “For many years stent retrieval intervention
has been done—a catheter is fed to the area that is blocked, with
a loop of wire that can evacuate the clot through the artery. This allows
Where the stroke takes place in the brain is a key factor in how the brain
is affected and chances of recovery.
“Smaller strokes that take place in the small arteries of brain that
we see in the older population can be very devastating,” says Gee.
“When they hit deep in brain they can cause a significant degree
of neurological symptoms and we can’t do our interventions.”
One positive point about strokes is that rehabilitation in the form of
speech and physical therapies can make a real difference in stroke recovery.
“It’s a must,” says Gee. “The brain is an ever-changing,
very dynamic organ. Different pathways in the brain can be created by
rehabilitation. We work hard on rehab for the patient to regain strength
and speech. If you don’t do rehabilitation the disabilities may
last longer,” he says, adding that rehab is often started the same
day the patient comes into the ER.
Learn more about
Dr. Gee. Learn more about
Mission Heritage Medical Group.