Brain imaging breakthrough provides new stroke care options

Someone in the U.S. has a stroke every 40 seconds, and someone dies of a stroke every 4 minutes. This is why emergency medical care for a person who may be having a stroke is so critical.

A stroke occurs when the blood supply to the brain is blocked or a blood vessel within the brain bursts, which can lead to brain damage, long-term disability and death. Early intervention is vital in the treatment of stroke to minimize the damage done to the brain. This is why it is so important to know the signs of stroke and call 911 immediately when they appear.

The mnemonic "BE FAST" offers a simple way to remember the most common signs of stroke - and how to respond.

B = Balance - Assess whether the person has a loss of balance. Are they unable to walk due to imbalance?
E = Eyes - Ask about the person's eyesight. Do they have loss of vision or double vision?

F = Face drooping - Ask the person to smile. Does 1 side droop?
A = Arm weakness - Ask the person to raise both arms. Does 1 arm drift downward?
S = Speech difficulty - Ask the person to repeat a simple sentence. Are the words slurred?
T = Time to call 911 - If the person shows any of these signs, call 911 immediately. Stroke treatment can begin in the ambulance.

Once a patient arrives at the hospital's emergency room and stroke is suspected, several tests can be used to diagnose stroke, determine a patient's prognosis and plan the best method of treatment. These tests commonly include magnetic resonance imaging (MRI), computed tomography (CT) scan, or tests of brain electrical activity and blood flow.

New brain imaging technology in use at Sharp hospitals
All Sharp HealthCare hospitals - Sharp Chula Vista Medical Center, Sharp Coronado Hospital, Sharp Grossmont Hospital, and Sharp Memorial Hospital - use computed tomography perfusion (CTP) imaging, which shows the areas of the brain that are adequately supplied with blood. CTP scans are analyzed by RAPID® brain imaging software, which almost instantly provides care providers with information about the type of stroke a person is having and assesses how much tissue can be saved.

"The CTP scans are used as an emergent diagnostic tool in assessing how much brain tissue can potentially be saved in patients with stroke symptoms," says Crystal Limonta, FNP-MSN, stroke program manager at
Sharp Chula Vista Medical Center. "CTP combined with RAPID software allows immediate access to results and expands the treatment window for endovascular therapy in patients with disabling strokes who would have previously been ineligible for treatment."

New opportunities for stroke treatment
Endovascular therapy is a nonsurgical treatment for the sudden loss of brain function due to stroke. The treatment is performed to stop the blockage of blood to the brain before it causes the brain tissue to die, thereby maintaining brain function and improving outcome. In the past, it was believed that all stroke patients must receive endovascular therapy within 6 hours of the onset of stroke to recover.

While this may be true for many stroke patients - and emergency care should always be sought - CTP imaging analyzed by RAPID software can identify patients' eligibility for thrombectomy - mechanically removing a blood vessel clot - beyond the normal 6-hour window and up to 24 hours after stroke for some patients.

The potential of an expanded window of time to treat a stroke patient with thrombectomy means that more people might have a greater chance for recovery. A 2018
study found that 45% of thrombectomy patients achieved independent functioning versus 17% of stroke patients who did not receive the procedure.

According to Limonta, CTP scans are completed on patients meeting the criteria outlined in the hospital's clinical practice guidelines established by the American Heart Association and American Stroke Association.

“Across the Sharp system, this technology has helped to improve the lives of our stroke patients by decreasing the amount of disability caused by strokes, and allowing them to return home more quickly, sometimes eliminating the need for a care facility entirely, after their stroke,” she says.

Sharp Grossmont is certified as a Comprehensive Stroke Center; Sharp Chula Vista and Sharp Memorial are certified as Advanced Primary Stroke Centers; and Sharp Coronado is certified as an Acute Stroke Ready Hospital. All are certified by The Joint Commission, an independent, not-for-profit certification and accreditation organization.