Methodist Hospital Stroke Center Among Nation’s Best

Lifesaving, clot-busting medication is only given to 2 percent of stroke patients who could benefit from the drug, despite increased hospital and public education campaigns.

Receiving tissue plasminogen activator, or tPA, within three hours of a stroke can increase the chances of recovery by 50 percent, said Dr. David Chiu, medical director of the Stroke Center at The Methodist Hospital.

Many hospitals, however, are poorly equipped to administer the drug safely.

Tissue plasminogen activator can be harmful if given improperly, Dr. Chiu said. Last year, a study published in the Journal of the American Medical Association showed that there were excessive complication rates following tPA administration, including fatal bleeding, in hospitals in the Cleveland, Ohio area.

"Health care providers need to be better educated on the uses of tPA so that the appropriate patients can receive the benefits of early treatment," said Dr. Chiu, whose stroke center is the only one in Houston to be named as a "Top 100" center for stroke treatment in the nation. "The message now is that if you think someone is having a stroke, don’t just go to a hospital ... go to a hospital with an established stroke center," he said.

The problem is that many hospitals do not have a stroke team to deal with an acute stroke patient using the most effective treatments. Efficiency and preparedness are critical, because every minute counts, he said.

And while health care providers need to be better educated, so do patients. In order to benefit from tPA, patients need to recognize the symptoms of stroke and get to a facility that administers the drug within three hours.

In a recent Stroke Center phone survey, Dr. Chiu said half of Houstonians called could not name one stroke symptom.

The symptoms of stroke are:

• sudden weakness or numbness of the face, arm, or leg, especially on one side of the body;
• sudden confusion or difficulty speaking or understanding;
• sudden problems with vision, such as dimness or loss of vision, in one or both eyes;
• sudden dizziness or problems with balance or coordination or sudden problems with movement or walking; and
• sudden severe headaches with no other known cause.

These symptoms may be more difficult to recognize than those of a heart attack and are therefore more often ignored by the people experiencing them, Dr. Chiu said. It is easy to learn that chest pain means you might be having a heart attack, but harder to recognize stroke symptoms, because often there is no pain, he said.

Stroke, also called brain attack, occurs when blood flow to the brain is disrupted. Disruption in blood flow is caused either when a blood clot blocks one of the blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke).

The incidence of stroke is increasing as a result of the aging population. Five years ago, the number of strokes in the United States was estimated to be 500,000 per year. Today, the figure exceeds 700,000.

For more information, visit http://www.methodisthealth.com/stroke or call (713) 790-3333 for a physician referral.

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©2006 Texas Medical Center

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