Think Fast

Think Fast

Two local Primary Stroke Centers utilize the latest technology to help save lives

By Jana J. Monji 01/21/2010

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You may think you’re too young to suffer a stroke, but if you’re reading this article, chances are you’re wrong, said Dr. Lance Lee, medical director of the Advanced Primary Stroke Center at Glendale Adventist Medical Center, who has treated stroke victims ranging from people in their late 20s to the elderly. 
“I recently had a 29-year-old patient who had a post-partum intravenous stroke,” Lee recalled in a recent phone interview. 
The use of birth control pills, smoking and certain genetic conditions can predispose a person toward having a stroke, and the symptoms are not particularly well-known, even though strokes are the third-leading cause of death and the leading cause of adult disability in the United States. 
Glendale Adventist is one of two certified Primary Stroke Centers serving the region. The other, Huntington Hospital in Pasadena, received certification in September as a Primary Stroke Center, a facility able to treat different types of stroke victims that has on hand a staff of physicians (an emergency room doctor, a neurologist, a neuro-interventionist and a neurosurgeon) that can provide comprehensive care. 
“Most people know what to look for with heart attacks, such as a chest pains. But people do not know about the symptoms of stroke and often wait for things to get better,” remarked Dr. Arbi Ohanian, director of the Huntington Hospital Primary Stroke Center.  
That’s a big mistake. Time is critical in such a situation. A stroke victim has only about three hours to get medical attention to prevent permanent brain damage, beginning at the onset of the symptoms, not from when he or she arrives at the emergency room. 
Ohanian recommended thinking FAST: Facial drooping or numbness; Arm weakness or numbness; Speaking difficulty to the point of being incomprehensible; and Time, which is limited. Don’t hesitate — dial 911.
According to Lee, “Los Angeles County changed their ambulance policy in November of last year so that stroke victims come to the nearest stroke center (instead of the nearest emergency room). That has made a huge different in recovery and survival,” he said.
It’s the lack of a sense of urgency and the public’s limited awareness of strokes that may prevent victims from going immediately to a hospital where they can have medication administered during the three-hour window. 
Other independent risk factors include diabetes, an elevated cholesterol level and an irregular heart rhythm, according to Lee. In these cases, preventative measures can be taken. Lee, who has been with Glendale Adventist for 11 years, stated that their stroke center was certified in March 2008 and was the first hospital in Los Angeles County, outside of universities, to gain certification. UCLA Medical Center was actually first.
In addition to the primary stroke center, Glendale Adventists has endovascular specialists who may be able to extend the treatment window for victims in some cases from three to five hours. 
One major tool in fighting the effects of a stroke soon after it occurs is the use of Tissue Plasminagen Activator, tPA, sometimes called "clot busters," because it dissolves blood clots and decreases disabilities caused by stroke. “In 2008, we gave three people tPA. Just last month, we treated the same number with tPA because we are a lot faster at reacting.” The Huntington center is involved in clinical trials on treatment with UCLA.”
Ohanian, who trained at UCLA, came to Huntington specifically to work at the stroke center. Recent advances in medicine have given patients renewed hope, he said. 
“If you look back 15, 20 years ago, we really didn’t have anything to offer stroke patients,” Ohanian said. “But in recent years, there have been several breakthroughs.” 


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