David Fiorella, MD, PhD
Michael Guido, MDWhile we hope that you or someone you love never have to experience a stroke, it’s important to know what to do if it does happen.
What is stroke?
Dr. Guido: There are two kinds of strokes: ischemic, in which a blockage prevents blood flow to the brain, and hemorrhagic, in which there is bleeding in or around the brain. Ischemic strokes are the most common, occurring in about 80 percent of cases in Suffolk County. You may have also heard the term TIA (transient ischemic attack), which is also known as a “mini stroke.” TIAs are caused by a temporary clot, which usually resolves within minutes to hours. They are often a precursor to a major stroke, so it’s important to take them seriously and see a doctor if you suspect you have had one.
Why is stroke awareness so important?
Dr. Fiorella: Stroke can affect people of all ages and backgrounds. It’s a leading cause of disability and the fifth-leading cause of death both for men and women in the United States — behind heart disease, chronic lung disease, cancer and unintentional injuries. Since 2011, stroke has dropped in the mortality rankings, which may be due in part to increased awareness of the signs, the importance of time and improvements in treatment.
What are the signs of stroke?
Dr. Guido: Signs of stroke include an uneven smile or facial droop, arm or leg numbness or weakness — especially on one side of the body, and slurred speech or difficulty speaking. Other warning signs include sudden confusion, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination, and a sudden severe headache with no known cause, often described as the worst headache of your life.
If you suspect you’re having a stroke, what should you do?
Dr. Fiorella: Get immediate help. Call the Suffolk County 911 system, where specially trained emergency medical dispatchers determine the location and type of call, and provide medical advice to the caller that can be initiated while an ambulance is en route. The 911 dispatcher will simultaneously dispatch a Stony Brook mobile stroke unit along with the local EMS provider to any potential stroke call. Stony Brook is collaborating with EMS agencies throughout Suffolk County to provide this lifesaving, time-sensitive care to our community.
How does a mobile stroke unit differ from a regular ambulance?
Dr. Fiorella: Mobile stroke units are designed to provide lifesaving care right at the scene, within the critical moments of a stroke before the patient even gets to the hospital. Each has a full crew of first responders, including a critical care nurse, paramedic, emergency medical technician (EMT), and computed tomography (CT) technologist. Medications including a clot-busting agent are also onboard as well as brain imaging equipment. Once the mobile stroke unit arrives on the scene, our stroke first responders onboard and our physicians back at Stony Brook University Hospital can communicate with the patient via telehealth, and accurately diagnose and determine the nearest, most appropriate hospital for the level of care required.
What if a special procedure is needed?
Dr. Fiorella: Our mobile stroke units greatly improve the chances of a good outcome because we can more rapidly identify if someone is a candidate for a mechanical thrombectomy, which is a procedure to remove clots that block large vessels. This means an individual must get to a hospital with the expertise and technology for this early enough to get the most benefit from the treatment
You’ve survived a stroke. Now what?
Dr. Guido: For thousands of Long Islanders who do survive a stroke, you’re not alone. Stony Brook’s Stroke Support Group can help. For more information, contact (631) 638-2638.
Want to know more about our mobile stroke units? Visit neuro.stonybrookmedicine.edu/mobile_stroke_units.
