Stroke

 

The Stroke Program at the University of Michigan brings together specialists in Neurology, Neurosurgery, Neurointerventional Radiology, Emergency Medicine, Vascular Surgery, Physical Medicine and Rehabilitation and Cardiology to offer the highest level of comprehensive stroke care to patients. This ranges from providing the most advanced stroke treatments to working with patients to identify the ways they can reduce their stroke risk. We are the first hospital in Michigan to achieve the American Heart Association’s (AHA) new Gold Plus rating for stroke care. This award recognizes hospitals that provide consistently excellent care following evidence based guidelines. The AHA has recognized the quality of stroke care provided at UMHS since 2005.

Our stroke clinic in the Cardiovascular Center is staffed by Board-certified stroke neurologists. We provide screening and preventive care to patients who are at high risk for stroke. We work with them to diagnose and treat conditions that increase risk for stroke. Our location in the Cardiovascular Center promotes collaboration with cardiologists and vascular surgeons. When interventions are needed, we work closely with Neurointerventional Radiology, Neurosurgery and Vascular Surgery. Together we put the best stroke prevention plan into action for each patient. This may range from lifestyle changes to the most sophisticated testing and treatment to decrease stroke risk.

Timing is critical in treating stroke. Our emergency response services, including Survival Flight, bring patients to our hospital quickly and safely. Once patients reach us, they are in good hands. Our stroke team provides the best emergency interventions and surgery 24 hours a day, seven days a week to minimize and sometimes reverse the effects of stroke.

Stroke patients are cared for in our dedicated Stroke Unit and Neuro-Intensive Care Unit (NICU). Vascular neurologists, neurosurgeons, neuroscience nurses with advanced training in stroke care, and a medical team who are experts in stroke treatment and complications, including physical, speech and language therapists and rehabilitation specialists, work together to determine the best plans for diagnosis, treatment, and prevention of future strokes. Stroke units have been shown to improve survival and functional outcomes following stroke, as well as decrease complications and the length of hospital stays. The use of these specially-trained physicians has been show to significantly improve stroke patient outcomes.

For patients who’ve had a hemorrhagic (bleeding) stroke, surgery may be necessary. When there is bleeding in the brain, the main surgical option is to place drains or monitors into the brain to remove fluid and lessen pressure inside the skull. Additionally, some patients may require either open surgery or less-invasive surgery through a blood vessel to stop ongoing bleeding.

An ischemic stroke occurs when a blood vessel is clogged, stopping blood from flowing to the brain properly. About 15 to 20 percent of these strokes are related to carotid artery disease, and in these cases surgery can help reduce the chance of future strokes. These procedures may also be indicated for patients who have had a TIA (transient ischemic attack), a temporary interruption of the blood flow to an area of the brain that is a warning sign stroke may soon follow.

Procedures include:

• Carotid endarterectomy, where a surgeon opens the artery, removes plaque and sutures the artery back in place
• Stent placement, to open the clogged vessel
• Bypass, where a vessel is removed from the leg and used to bypass a blood vessel to the brain that’s completely clogged

Some patients who have had major ischemic strokes and are experiencing brain swelling may also need to have a portion of the skull removed to allow more room for the brain to swell. Once the swelling has subsided, which can take several weeks, the removed portion of the skull is put back into place, and the patient continues his or her recovery.

Patients begin working with occupational and physical therapists, and speech and language pathologists as soon as they are medically ready. If therapy is needed after discharge, we work with patients and their families to plan the best recovery strategies.

We are accredited as a Primary Stroke Center by the Joint Commission on Accreditation of Healthcare Organizations and participate in the American Stroke Association "Get With The Guidelines®" Quality Initiative.

The University of Michigan Stroke Program is at the forefront of research to make a difference in the lives of stroke patients and their families. Much of our research is supported by the National Institutes of Health. We are involved in multiple studies for ischemic stroke, including researching new medications to dissolve clots and new techniques that restore blood flow to the brain before significant damage is done. We also offer ongoing clinical trials for stroke patients.