A stroke is a serious neurological event that can cause permanent damage and even death, so time is of the essence when treating stroke, says Dr. Andre Douen, department head of neurology at Trillium Health Centre.
But how do you know if you're having a stroke?
says the signs and symptoms of a stroke include "weakness, so loss of the use of an arm or leg, or weakness of the face.
Numbness, particularly if it involves one side the body, involving the arm or leg, again, sometimes the face.
Loss of speech, loss of vision and dizziness is in there," he
says, but usually only "if in association with one of the other components I mentioned, such as loss of speech, slurring of speech, or weakness on one side of the body."
goes on to explain that there are many risk factors that can lead to stroke, the main one being getting older.
"So a lot of seniors are at risk just from aging," explains Douen
The wear and tear on the body and the blood vessels leads to plaque formation, which Douen
describes as crud in the blood vessels, and can sometimes cause additional clots to form.
Whether surgery is required or not, Douen
reiterates that it's important for the public to be aware of the signs and symptoms of stroke so they can present to the emergency department of their local hospital if they suspect they are suffering from a stroke.
The reason being, Douen
explains, is because "we do have clot busting drugs.
The one that we use for stroke patients is called TPA, that's the shortened name of it.
And we have to administer that drug to non-bleeding strokes within about four and a half hours of the event occurring."
Additionally, "CT scans have to be done before the patient is treated to make sure that there's no blood in the brain.
goes on, "if the opportunity is there, we would administer TPA to the patient.
It does carry a small risk of bleeding, about six per cent, but there's overwhelming benefit from using the drug in stroke patients."
Other types of investigation done when someone presents with a stroke include regular blood work to ensure there's nothing wrong with the patient's electrolytes or hemoglobin.
An ECG is done to monitor the heart rate because there are some types of heart rates that may be associated with stroke.
"The CT scan is done," Douen
says again, "to make sure it's an ischemic stroke, that's the non-bleeding stroke, as compared to a bleeding stroke, because the management is a little different."
A carotid doppler, or an ultrasound of the blood vessels of the neck, is done, "not necessarily in the acute setting," Douen
says, "but certainly within the next two or three days following the stroke."
This is important because plaque build-up, or atherosclerosis, narrows the blood vessels, which can lead to further clot formation.
"Those clots," Douen
says, "can either block the blood vessel directly in the neck, or sometimes they break off and shoot towards the brain.
And that's where we need to understand if there's blockage then we may give the opportunity for probably a surgical procedure to open up that blood vessel, if the patient is a good surgical candidate."
For cases in which a surgical maneuver to clear the plaque isn't an option, Douen
says "there might be an opportunity there to get in and to balloon that open, balloon the narrowing open, and sometimes leaving an alloy, a piece of metal behind, as we refer to as a stent, to hold the blood vessel open."
explains that he
says "there may be an opportunity," because "I don't actually want to give the impression that it's available for everyone, we do select patients carefully to make sure that the benefit outweighs the risk."
At Trillium Health Centre
, all of these investigations and tools are available to patients suffering a stroke in Oakville, Mississauga, Brampton, as far north as Orangeville, and parts of Etobicoke.
is a regional stroke centre," says Douen
, "so we do have the entire service available for treating patients," including a 24 hour stroke service, an intensive care stroke unit, and of course neurosurgeons to assist with surgical procedures, when required.