Suspect a stroke? Seek treatment as ‘F.A.S.T.’ as possible


Dr. Richard Callison, a board-certified neurologist with HCA Florida Lawnwood Hospital, says emphatically that time is the key to surviving a stroke. “The brain dies 10 times faster than the heart, so it is imperative if you recognize any signs of stroke that you call 911 immediately,” he said.

“Don’t drive yourself or your loved one, even if you are close to the hospital, because the EMS paramedics are trained to identify which type of stroke it is and make a determination on which hospital to go to for your treatment. If you show up at the wrong emergency room, they may have to transport you to the appropriate stroke center and every second counts for your survival.”

May is stroke awareness month and experts say someone in the United States has a stroke every 40 seconds, resulting in one out of every 19 deaths.

“There are multiple kinds of strokes, but the two primary ones are ischemic and hemorrhagic,” said Dr. Callison. “The most common is the ischemic stroke that occurs when not enough blood is flowing to the brain. It’s essentially a brain’s equivalent of a heart attack.

Part of the brain dies when a blood vessel in the brain gets blocked off or clotted, and it deprives that part of brain enough oxygen.

“About 87 percent of strokes are ischemic and result in blood clots in the brain. The other 13 percent of strokes are hemorrhagic, which occur when a blood vessel within the brain ruptures and bleeds into the surrounding brain tissue.

“A TIA (Transient Ischemic Attack) is called a mini-stroke and is a warning sign to a stroke,” Dr. Callison continued. “It’s basically the same thing as having chest pain prior to a heart attack. It occurs when part of the brain is being deprived of oxygen and is no longer functioning properly, however blood flow via the body’s own mechanism is restored and there is no permanent injury to the brain.

“A lot of people discount the importance of a TIA, but it is extremely important because that is the time to intervene without permanent injury and prevent a full-blown stroke in the future.

When a TIA occurs, the chance of having a full-blown stroke is the highest in the first 48 hours and within the first month.”

Strangely enough you can actually have a TIA and not know it. Dr. Callison explained that certain parts of the brain can do funny things when damaged and convince a person that there is nothing wrong with them. “I’ve had patients sitting on the floor for days next to a phone and not do anything because their brain was telling them that there was nothing wrong with them even though they couldn’t move their left side or function properly,” he said.

Stroke used to be the fourth leading cause of death in the U.S., but thanks to better treatments it is now ranked fifth.

“The biggest thing that came about – back in 2013 – was new equipment that gave us the ability to recanalize large blood vessels,” Dr. Callison said. “When a bigger vessel inside the brain becomes blocked, this new equipment allows us to go in and pull that clot out more effectively than in the past. Prior to that, we were only 60 percent effective in being able to get the clot out; now our ability to recanalize is more than 95 percent. When I was in fellowship I would walk into a case thinking, ‘I hope I can get the vessel open,’ but now I walk in thinking, ‘how quickly can I get the vessel open?’”

The blood clot is removed with a retrievable stent that expands and incorporates the clot and in doing so it opens up the blood vessel. While the stent is in place, the blood flow is restored despite the fact that there is a clot still in there. Once the stent is removed the blood flow is completely restored. The chances of survival are greater when emergency treatment begins quickly with patients arriving at the emergency room within three hours of their first symptom having less disability after a stroke than those who received delayed care.

Stroke recovery time varies, depending on how quickly the stroke was treated and how much damage was done. Generally speaking, the maximum point of recovery is six months, but people can still show signs of additional recovery one or two years out. Recovery requires physical and speech therapy for best results in most cases.

“At HCA Florida Lawnwood Hospital we have stroke doctors on call 24 hours a day, 7 days a week, 365 days a year to ensure that regardless of what type of stroke you are presenting, we have the personnel and technology to treat it and provide the best chance for recovery,” Dr. Callison said. “Just remember to act F.A.S.T.”

F.A.S.T. is an acronym that encapsulates the warning signs of a stroke:

F. Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the smile uneven?
A. Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S. Speech Difficulty – Is speech slurred?
T. Time to call 911.

Other stroke symptoms include:

  • Numbness or weakness of face, arm or leg especially on one side of the body.
  • Trouble speaking or understanding speech.
  • Trouble seeing in one or both eyes.
  • Trouble walking, dizziness, loss of balance or coordination.
  • Severe headache with no known cause.

HCA Florida Lawnwood Hospital offers the area’s first facility recognized as a Primary Stroke Center and Advanced Thrombectomy Capable Stroke Center by the Joint Commission as well as a Comprehensive Stroke Center by the Florida Agency for Health Care Administration.

Dr. Richard Callison earned his medical degree from University of Missouri, Kansas City. He completed his neurology residency at Saint Louis University School of Medicine and cerebrovascular and interventional neuroradiology fellowships at the University of Iowa Hospitals and Clinics in Iowa City. He has been part of the stroke team at HCA Florida Hospital for three years. His office is located at 2402 Frist Blvd., Suite 201, Fort Pierce; the office number is 772-460-8838.

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