Primary Stroke Center

According to the American Stroke Association, stroke is the 4th leading cause of death in the United States. On average, a stroke occurs every 40 seconds in America, and every four minutes, someone dies from a stroke. Recognizing the prevalence of stroke in the community, the Primary Stroke Center at GBMC provides care to patients who have had a stroke or Transient Ischemic Attack (TIA).

GBMC's Advanced Certification for Primary Stroke Centers, awarded by The Joint Commission in conjunction with the American Heart/American Stroke Association, demonstrates that it meets critical elements of performance to achieve long-term success in improving outcomes for stroke patients. Additionally, GBMC is recognized as a Primary Stroke Center by the Maryland Institute for Emergency Medicine Services Systems (MIEMSS).

The Primary Stroke Center at GBMC is ranked as one of the hospitals in Maryland with the highest stroke survival rates for inpatient stay, 1 month post-discharge and 6 months post-discharge based on data provided by the Centers for Medicaid and Medicare (CMS) Services. The Primary Stroke Center has also earned the Gold Plus Achievement Award by the American Heart/American Stroke Association, an honor that represents sustained high quality by nursing and physician teams.

Get With the Guidelines Gold Plus Award

The American Heart Association and American Stroke Association recognize GBMC for achieving 85 percent or higher adherence to all Get With The Guidelines Stroke Performance Achievement indicators for consecutive 12-month intervals, and 75 percent or higher compliance with 5 of 8 Get With The Guidelines Stroke Quality Measures, to improve quality of patient care and outcomes in addition to achieving Time to Intravenous Thrombolytic Therapy < 60 minutes in 50% or more of applicable acute ischemic stroke patients (minimum of 6) during one calendar quarter.

This award recognizes GBMC's commitment to success in implementing a higher standard of stroke care, according to evidenced-based guidelines.

Stroke Symptoms – F.A.S.T.

Recognizing a stroke early and immediately calling 911 is critical to a person's outcome. So, when it comes to stroke, remember to think F.A.S.T. and use the following acronym provided by the American Stroke Association to quickly identify stroke symptoms in yourself or others:
  • Face drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
  • Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?
  • Time to call 911: If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared.
Other stroke symptoms come on suddenly and include confusion, trouble speaking or understanding ; trouble seeing in one or both eyes; trouble walking, dizziness, loss of balance or coordination; and severe headache. Download our infographic so that you can always remember the signs to look for.

Types of Stroke

A stroke can occur if either a blood vessel leading to the brain is blocked by a clot (ischemic stroke) or bursts (hemorrhagic stroke). This keeps essential oxygen and nutrients from reaching the affected part of the brain, so it begins to die.

Ischemic Stroke
Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This may happen in two ways:
  • A clot may form in an artery that is already very narrow. This is called a thrombus. If it completely blocks the artery, it is called a thrombotic stroke.
  • A clot may break off from another place in the blood vessels of the brain, or some other part of the body, and travel up to the brain to block a smaller artery. This is called an embolism. It causes an embolic stroke.
Hemorrhagic Stroke
Hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open, causing blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. The flow of blood that occurs after the blood vessel ruptures damages brain cells.

Transient Ischemic Attack (TIA)
A transient ischemic attack or TIA is often referred to as a "warning stroke" or "mini-stroke." The term "mini-stroke" is misleading and diminishes the importance of a TIA. While a TIA does not result in permanent damage, it is a warning sign of possible impending stroke. A person experiencing a TIA should seek medical attention. Immediate treatment can significantly reduce risk of stroke in the future.

Risk Factors

According to the American Stroke Association, factors such as medical conditions, behaviors and heredity can play a role in stroke risk. Your primary care physician can help you determine your stroke risk and come up with a plan to reduce the number of controllable risk factors, such as blood pressure, cholesterol and obesity.

The following medical conditions can increase risk:
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Diabetes
  • Overweight and obesity
  • Previous stroke or transient ischemic attack (TIA)
  • Sickle cell disease
The following behaviors can increase risk:
  • Tobacco use
  • Alcohol use
  • Physical inactivity
The following hereditary traits can increase risk:
  • Family history
  • Age and gender – older people are at higher risk, as are men
  • Race and ethnicity – African-American, Latino, American Indian/Alaska Native individuals are at higher risk than non-Hispanic whites or Asians

Diagnosis and Treatment

Diagnosis

Several imaging studies are utilized, in addition to a physical exam and blood work, to diagnose stroke and identify a person's stroke risk.
  • Carotid Ultrasound – shows potential blockages in the carotid arteries of the neck
  • Brain Imaging, such as Computerized Tomography (CT Scan) and Magnetic Resonance Imaging (MRI) – shows detailed images of the brain to identify or rule out ischemic or hemorrhagic stroke; detects damage of the brain tissue
  • Angiogram – locates abnormal and blocked blood vessels in the brain
  • Echocardiogram – offers detailed images of the heart to help determine the possible source of a blood clot that may have traveled to the brain
Treatment

Stroke treatment varies from medication to surgery depending on the type of stroke, severity of stroke and location in the brain. Ischemic patients who make it to the hospital within three hours of symptom onset may receive an FDA-approved clot-busting drug that can increase the chance of full recovery from a stroke without permanent disability."  In addition to focusing on preventing future strokes, survivors may need additional rehabilitation services.

Resources

Greater Baltimore Medical Center | 6701 North Charles Street | Baltimore, MD 21204 | (443) 849-2000 | TTY (800) 735-2258
© 2014  GBMC. This website is for informational purposes only and not intended as medical advice or a substitute for a consultation with a professional healthcare provider.