Englewood Hospital is a Primary Stroke Center, designated by The Joint Commission. Using a team approach through all phases of stroke care, from pre-hospital ambulance response through assessment, treatment, and rehabilitation, we take into consideration the special needs of stroke patients and their families. We recognize and support the importance of education for all staff and patients, and we support education for the community in stroke prevention, awareness, and treatment.
Care & Treatment
About Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a “brain attack.” If blood flow is cut off for longer than a few seconds, the brain cannot get nutrients and oxygen. Brain cells can die, causing lasting damage.
There are two major types of stroke:
- Ischemic stroke
- Hemorrhagic 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 thrombotic stroke.
- A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. This is called cerebral embolism, or an embolic stroke.
Ischemic strokes may also be caused by a sticky substance called plaque that can clog arteries.
A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open. This causes blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. These defects may include:
- Aneurysm
- Arteriovenous malformation (AVM)
Hemorrhagic strokes may also occur when someone is taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke.
An ischemic stroke can develop bleeding and become a hemorrhagic stroke.
High blood pressure is the main risk factor for strokes. The other major risk factors are:
- Atrial fibrillation
- Diabetes
- Family history of stroke
- High cholesterol
- Increasing age, especially after age 55
- Race (black people are more likely to die of a stroke)
Stroke risk is also higher in:
- People who have heart disease or poor blood flow in their legs caused by narrowed arteries
- People who have unhealthy lifestyle habits such as smoking, a high fat diet, and lack of exercise
- Women who take birth control pills (especially those who smoke and are older than 35)
- Women who are pregnant have an increased risk while pregnant
- Women who take hormone replacement therapy
The symptoms of stroke depend on which part of the brain is damaged. In some cases, a person may not know that a stroke has occurred.
Most of the time, symptoms develop suddenly and without warning. However, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.
A headache may occur if the stroke is caused by bleeding in the brain. The headache:
- Starts suddenly and may be severe
- May be worse when you are lying flat
- Wakes you up from sleep
- Gets worse when you change positions or when you bend, strain, or cough
Other symptoms depend on how severe the stroke is and what part of the brain is affected. Symptoms may include:
- Change in alertness (including sleepiness, unconsciousness, and coma)
- Changes in hearing
- Changes in taste
- Changes that affect touch and the ability to feel pain, pressure, or different temperatures
- Clumsiness
- Confusion or loss of memory
- Difficulty swallowing
- Difficulty writing or reading
- Dizziness or abnormal feeling of movement (vertigo)
- Eyesight problems, such as decreased vision, double vision, or total loss of vision
- Lack of control over the bladder or bowels
- Loss of balance
- Loss of coordination
- Muscle weakness in the face, arm, or leg (usually just on one side)
- Numbness or tingling on one side of the body
- Personality, mood, or emotional changes
- Trouble speaking or understanding others who are speaking
- Trouble walking
The doctor will do a physical exam to:
- Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or improving.
- Listen for an abnormal sound, called a “bruit,” when using a stethoscope to listen to the carotid arteries in the neck. A bruit is caused by abnormal blood flow.
- Check for high blood pressure
You may have the following tests to help find the type, location, and cause of the stroke and rule out other disorders:
- Angiogram of the head to look for a blood vessel that is blocked or bleeding
- Carotid duplex (ultrasound) to see if the carotid arteries in your neck have narrowed
- Echocardiogram to see if the stroke could have been caused by a blood clot from the heart
- Magnetic resonance angiography (MRA) or CT angiography to check for abnormal blood vessels in the brain
Other tests include:
- Blood tests
- Electrocardiogram (ECG) and heart rhythm monitoring
A stroke is a medical emergency. Quick treatment is needed. Call 911 or your local emergency number or seek urgent medical care at the first signs of a stroke.
People who are having stroke symptoms need to get to a hospital as quickly as possible.
- If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot.
- To be effective, this treatment must be started within 3 to 4 1/2 hours of when the symptoms first started. The sooner this treatment is started, the better chances of a good outcome.
Other treatments given in the hospital will depend on the cause of the stroke. These may include:
- Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix)
- Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol
- Special procedures or surgery to relieve symptoms or prevent more strokes
- Nutrients and fluids
Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed.
The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes.
Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home.
How well a person does after a stroke depends on:
- The type of stroke
- How much brain tissue is damaged
- What body functions have been affected
- How quickly treatment is given
Problems moving, thinking, and talking often improve in the weeks to months after a stroke.
Many people who have had a stroke will keep improving in the months or years after their stroke.
Over half of people who have a stroke are able to function and live at home. Others are not able to care for themselves.
If treatment with clot-busting drugs is successful, the symptoms of a stroke may go away. However, patients often do not get to the hospital soon enough to receive these drugs, or they cannot take these drugs because of a health condition.
People who have a stroke due to a blood clot (ischemic stroke) have a better chance of surviving than those who have a stroke due to bleeding in the brain (hemorrhagic stroke).
The risk for a second stroke is highest during the weeks or months after the first stroke. The risk begins to decrease after this period.
About Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a “brain attack.” If blood flow is cut off for longer than a few seconds, the brain cannot get nutrients and oxygen. Brain cells can die, causing lasting damage.
There are two major types of stroke:
- Ischemic stroke
- Hemorrhagic 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 thrombotic stroke.
- A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. This is called cerebral embolism, or an embolic stroke.
Ischemic strokes may also be caused by a sticky substance called plaque that can clog arteries.
A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open. This causes blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. These defects may include:
- Aneurysm
- Arteriovenous malformation (AVM)
Hemorrhagic strokes may also occur when someone is taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke.
An ischemic stroke can develop bleeding and become a hemorrhagic stroke.
High blood pressure is the main risk factor for strokes. The other major risk factors are:
- Atrial fibrillation
- Diabetes
- Family history of stroke
- High cholesterol
- Increasing age, especially after age 55
- Race (black people are more likely to die of a stroke)
Stroke risk is also higher in:
- People who have heart disease or poor blood flow in their legs caused by narrowed arteries
- People who have unhealthy lifestyle habits such as smoking, a high fat diet, and lack of exercise
- Women who take birth control pills (especially those who smoke and are older than 35)
- Women who are pregnant have an increased risk while pregnant
- Women who take hormone replacement therapy
The symptoms of stroke depend on which part of the brain is damaged. In some cases, a person may not know that a stroke has occurred.
Most of the time, symptoms develop suddenly and without warning. However, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.
A headache may occur if the stroke is caused by bleeding in the brain. The headache:
- Starts suddenly and may be severe
- May be worse when you are lying flat
- Wakes you up from sleep
- Gets worse when you change positions or when you bend, strain, or cough
Other symptoms depend on how severe the stroke is and what part of the brain is affected. Symptoms may include:
- Change in alertness (including sleepiness, unconsciousness, and coma)
- Changes in hearing
- Changes in taste
- Changes that affect touch and the ability to feel pain, pressure, or different temperatures
- Clumsiness
- Confusion or loss of memory
- Difficulty swallowing
- Difficulty writing or reading
- Dizziness or abnormal feeling of movement (vertigo)
- Eyesight problems, such as decreased vision, double vision, or total loss of vision
- Lack of control over the bladder or bowels
- Loss of balance
- Loss of coordination
- Muscle weakness in the face, arm, or leg (usually just on one side)
- Numbness or tingling on one side of the body
- Personality, mood, or emotional changes
- Trouble speaking or understanding others who are speaking
- Trouble walking
The doctor will do a physical exam to:
- Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or improving.
- Listen for an abnormal sound, called a “bruit,” when using a stethoscope to listen to the carotid arteries in the neck. A bruit is caused by abnormal blood flow.
- Check for high blood pressure
You may have the following tests to help find the type, location, and cause of the stroke and rule out other disorders:
- Angiogram of the head to look for a blood vessel that is blocked or bleeding
- Carotid duplex (ultrasound) to see if the carotid arteries in your neck have narrowed
- Echocardiogram to see if the stroke could have been caused by a blood clot from the heart
- Magnetic resonance angiography (MRA) or CT angiography to check for abnormal blood vessels in the brain
Other tests include:
- Blood tests
- Electrocardiogram (ECG) and heart rhythm monitoring
A stroke is a medical emergency. Quick treatment is needed. Call 911 or your local emergency number or seek urgent medical care at the first signs of a stroke.
People who are having stroke symptoms need to get to a hospital as quickly as possible.
- If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot.
- To be effective, this treatment must be started within 3 to 4 1/2 hours of when the symptoms first started. The sooner this treatment is started, the better chances of a good outcome.
Other treatments given in the hospital will depend on the cause of the stroke. These may include:
- Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix)
- Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol
- Special procedures or surgery to relieve symptoms or prevent more strokes
- Nutrients and fluids
Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed.
The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes.
Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home.
How well a person does after a stroke depends on:
- The type of stroke
- How much brain tissue is damaged
- What body functions have been affected
- How quickly treatment is given
Problems moving, thinking, and talking often improve in the weeks to months after a stroke.
Many people who have had a stroke will keep improving in the months or years after their stroke.
Over half of people who have a stroke are able to function and live at home. Others are not able to care for themselves.
If treatment with clot-busting drugs is successful, the symptoms of a stroke may go away. However, patients often do not get to the hospital soon enough to receive these drugs, or they cannot take these drugs because of a health condition.
People who have a stroke due to a blood clot (ischemic stroke) have a better chance of surviving than those who have a stroke due to bleeding in the brain (hemorrhagic stroke).
The risk for a second stroke is highest during the weeks or months after the first stroke. The risk begins to decrease after this period.
F.A.S.T. – When to Call 911
Stroke is a medical emergency that needs to be treated right away. The acronym F.A.S.T. is an easy way to remember signs of stroke and what to do if you think a stroke has occurred. The most important action to take is to immediately call 911 for emergency assistance.
F.A.S.T. stands for:
- FACE. Ask the person to smile. Check to see if one side of the face droops.
- ARMS. Ask the person to raise both arms. See if one arm drifts downward.
- SPEECH. Ask the person to repeat a simple sentence. Check to see if words are slurred and if the sentence is repeated correctly.
- TIME. If a person shows any of these symptoms, time is essential. It is important to get to the hospital as quickly as possible. Call 911. Act F.A.S.T.
Reconozca los síntomas de un ataque cerebrovascular
Utilice la prueba FAST para reconocer y responder de inmediato.
- FACE (cara) Rostro caído
- ARM (brazo) Brazo débiles
- SPEECH (habla) Dificultad para comunicarse
- TIME (tiempo) Si observa alguno de estos signos, llame de inmediato al 9-1-1
Si usted responde afirmativamente (¡Sí!) a una de estas preguntas, Llame al 9-1-1 y avise que está sufriendo un “STROKE” (pronunciado “ESTROUK”).
F.A.S.T. 로 뇌졸증 조기발견
당신뿐만 아니라 다른이의 목숨도 구할수 있습니다.
- FACE (얼굴) 쳐지거나 감각이 무뎌졌을때
- ARM (팔) 힘이 없을때
- SPEECH (말) 발음이 불분명할때
- TIME (시간) 이런증상이 하나라도 있으시거나, 증상이 사라져도 911로 꼭 연락하세요.
F.A.S.T. – When to Call 911
Stroke is a medical emergency that needs to be treated right away. The acronym F.A.S.T. is an easy way to remember signs of stroke and what to do if you think a stroke has occurred. The most important action to take is to immediately call 911 for emergency assistance.
F.A.S.T. stands for:
- FACE. Ask the person to smile. Check to see if one side of the face droops.
- ARMS. Ask the person to raise both arms. See if one arm drifts downward.
- SPEECH. Ask the person to repeat a simple sentence. Check to see if words are slurred and if the sentence is repeated correctly.
- TIME. If a person shows any of these symptoms, time is essential. It is important to get to the hospital as quickly as possible. Call 911. Act F.A.S.T.
Reconozca los síntomas de un ataque cerebrovascular
Utilice la prueba FAST para reconocer y responder de inmediato.
- FACE (cara) Rostro caído
- ARM (brazo) Brazo débiles
- SPEECH (habla) Dificultad para comunicarse
- TIME (tiempo) Si observa alguno de estos signos, llame de inmediato al 9-1-1
Si usted responde afirmativamente (¡Sí!) a una de estas preguntas, Llame al 9-1-1 y avise que está sufriendo un “STROKE” (pronunciado “ESTROUK”).
F.A.S.T. 로 뇌졸증 조기발견
당신뿐만 아니라 다른이의 목숨도 구할수 있습니다.
- FACE (얼굴) 쳐지거나 감각이 무뎌졌을때
- ARM (팔) 힘이 없을때
- SPEECH (말) 발음이 불분명할때
- TIME (시간) 이런증상이 하나라도 있으시거나, 증상이 사라져도 911로 꼭 연락하세요.
Our Team Approach
Our Stroke Center team is made up of physicians, nurses, and other professionals in neurology and neurosurgery, emergency medicine, critical care, interventional cardiology, emergency medical services, rehabilitation medicine, radiology, laboratory, pharmacy, dietary, and other areas. We work together to provide the highest-quality care for stroke patients, across all stages of stroke care. Our ambulance team is trained to recognize the symptoms of stroke and are prepared to alert the Emergency Department of the imminent arrival by ambulance of a possible stroke patient. When a stroke patient arrives, our team does an immediate assessment and CT scan, which is located in the Emergency Department’s in-house imaging suite. The brain scan is reviewed by a neurologist, who will then decide the appropriate treatment. After being treated and stabilized, patients are admitted to our stroke unit, where rehabilitation will begin shortly thereafter. Physical, speech, and occupational therapists will work together with patients and families through the recovery process and in planning the transition home or to a rehab facility.
Our Team Approach
Our Stroke Center team is made up of physicians, nurses, and other professionals in neurology and neurosurgery, emergency medicine, critical care, interventional cardiology, emergency medical services, rehabilitation medicine, radiology, laboratory, pharmacy, dietary, and other areas. We work together to provide the highest-quality care for stroke patients, across all stages of stroke care. Our ambulance team is trained to recognize the symptoms of stroke and are prepared to alert the Emergency Department of the imminent arrival by ambulance of a possible stroke patient. When a stroke patient arrives, our team does an immediate assessment and CT scan, which is located in the Emergency Department’s in-house imaging suite. The brain scan is reviewed by a neurologist, who will then decide the appropriate treatment. After being treated and stabilized, patients are admitted to our stroke unit, where rehabilitation will begin shortly thereafter. Physical, speech, and occupational therapists will work together with patients and families through the recovery process and in planning the transition home or to a rehab facility.
Quality and Accreditation
Englewood Hospital is a designated Primary Stroke Center, last accredited by The Joint Commission in 2016.
The Joint Commission’s Primary Stroke Center Certification Program, launched in December 2003, was developed in collaboration with the American Heart Association/American Stroke Association (AHA/ASA). The Certificate of Distinction for Primary Stroke Centers recognizes centers that follow the best practices for stroke care. Certified primary stroke centers:
- Use a standardized method of delivering care
- Support patient self-management activities
- Tailor treatment and intervention to individual needs
- Promote the flow of patient information across settings and providers, while protecting patient rights, security and privacy
- Analyze and use standardized performance measure data to continually improve treatment plans
- Demonstrate their application of and compliance with clinical practice guidelines published by the AHA/ASA or equivalent evidence-based guidelines
For more information about Primary Stroke Center accreditation, visit The Joint Commission website.
Quality and Accreditation
Englewood Hospital is a designated Primary Stroke Center, last accredited by The Joint Commission in 2016.
The Joint Commission’s Primary Stroke Center Certification Program, launched in December 2003, was developed in collaboration with the American Heart Association/American Stroke Association (AHA/ASA). The Certificate of Distinction for Primary Stroke Centers recognizes centers that follow the best practices for stroke care. Certified primary stroke centers:
- Use a standardized method of delivering care
- Support patient self-management activities
- Tailor treatment and intervention to individual needs
- Promote the flow of patient information across settings and providers, while protecting patient rights, security and privacy
- Analyze and use standardized performance measure data to continually improve treatment plans
- Demonstrate their application of and compliance with clinical practice guidelines published by the AHA/ASA or equivalent evidence-based guidelines
For more information about Primary Stroke Center accreditation, visit The Joint Commission website.
Community and Patient Education
An important part of our Stroke Center mission is education for patients, EMS professionals, and the community. All patients with stroke or at high risk for stroke are offered educational materials from the American Heart Association/American Stroke Association in English, Spanish, and Korean.
Through participation in health fairs and community events, we educate the public on how to reduce the risk of stroke, how to identify stroke warning signs, and the importance of call 911 immediately when someone is experiencing warning signs. We welcome requests and inquiries from community organizations on how we can work together to raise awareness of stroke. Contact us now.
Community and Patient Education
An important part of our Stroke Center mission is education for patients, EMS professionals, and the community. All patients with stroke or at high risk for stroke are offered educational materials from the American Heart Association/American Stroke Association in English, Spanish, and Korean.
Through participation in health fairs and community events, we educate the public on how to reduce the risk of stroke, how to identify stroke warning signs, and the importance of call 911 immediately when someone is experiencing warning signs. We welcome requests and inquiries from community organizations on how we can work together to raise awareness of stroke. Contact us now.
Awards
Carechex Patient Safety Award
• Stroke Care – Top 10% in Nation
Awards
Carechex Patient Safety Award
• Stroke Care – Top 10% in Nation
