McLeod: RAPID Care of Stroke

Dr. Ravish Kothari, McLeod Vascular Neurologist; Dr. Joseph Kearney, McLeod Emergency Physician; and Dr. Timothy Hagen, McLeod Neurologist, are part of the McLeod team who receive the RAPID reports and expedite stroke care at all McLeod Health hospitals.

RAPID Care of Stroke

story by Dr. Timothy Hagen, Medical Director of McLeod Neurology Services

A stroke happens when blood flow to an area in the brain is cut off. If not caught early permanent brain damage can occur. That is why every minute counts for a stroke patient when it comes to treatment. The most effective stroke treatment can only be implemented once the stroke is diagnosed. McLeod Health has installed new software that expedites stroke care for patients. The RAPID imaging technology quickly analyzes a head CT scan of patients experiencing acute strokes. The software is fast and automated with results being viewed on any computer or handheld device by the McLeod Neurology Medical Team. Within minutes, scans with stroke test results are being sent to McLeod Neurologists, the Interventional Neuroradiologist, Emergency Physicians, Anesthesiologists, and Critical Care Specialists. RAPID quickly provides these McLeod Specialists with patient information, allowing them to rapidly assess the severity of the patient’s stroke and determine the most appropriate treatment. The faster patient information is delivered, the sooner treatment can begin and that can potentially be brain saving or even life saving for the patient. A CT scan of the head is performed to help distinguish between Ischemic stroke or a Hemorrhagic stroke. It is important to know which type of stroke it is to be able to determine the treatment plan. Ischemic strokes occur when a blood vessel to the brain is blocked by a clot. When this happens part of the brain is not getting the oxygen and blood it needs, which is a very dangerous and life-threatening situation. Ischemic strokes are the most common type of stroke accounting for 87 percent of all strokes, according to the American Stroke Association.

The main treatment for patients diagnosed with an Ischemic stroke is a drug called tissue plasminogen activator (tPA), which breaks up clots. The benefits of tPA are time dependent and should be administered as quickly as possible. The window of opportunity for giving the medication is four and half hours after the onset of a stroke. The

speed of RAPID helps ensure more patients are not out of the window for tPA.

When RAPID scans indicate a larger brain vessel blockage, the vessels can be re-opened quickly and safely with a procedure called Thrombectomy. A minimally invasive surgery, this procedure removes the blood clot from a brain artery. Time is also of the essence when restoring blood flow back to the brain. And, not all hospitals are equipped with the staff, training and equipment necessary to perform a Thrombectomy. At McLeod Regional Medical Center, there is a dedicated Neurointerventional Bi-plane X-ray Suite for such procedures as Thrombectomy. The Bi-plane imaging system produces highly detailed three-dimensional views of blood vessels heading to the brain and deep within the brain. Designed for the emergency treatment of stroke patients, this technology allows doctors to follow the blood flow path to the exact location of the issue.

The Thrombectomy procedure for stroke care is also performed by an Interventional Neuroradiologist. This specialist uses the Bi-plane X-ray imaging to help guide a catheter, a long flexible tube, inserted through an artery in the groin up to the blocked artery. Once there, a stent retriever, a tiny net-like device, is inserted into the catheter and guided to the blockage to capture the clot and return blood flow back to the brain. At McLeod, we are pleased to offer the RAPID technology to reduce the time between stroke treatment and care for our patients. Patients in the region have the comfort of knowing this service is available at all McLeod Health hospitals: McLeod Regional Medical Center, McLeod Health Clarendon, McLeod Health Cheraw, McLeod Health Dillon, McLeod Health Carolina Forest, McLeod Health Loris, and McLeod Health Seacoast.

Dr. Timothy Hagen

Medical Director of Neurology Services

Dr. Timothy Hagen is a McLeod Hospital Neurologist who is board certified in Neurology and Sleep Medicine. He received his medical degree from Western University in Pomona, California. Dr. Hagen completed an Internal Medicine Residency at Good Samaritan Hospital in Cincinnati, Ohio, and a Neurology Residency at the University of Cincinnati in Ohio. Dr. Hagen cares for patients at McLeod Regional Medical Center.

Every minute counts for stroke patients and acting F.A.S.T. can lead patients to the stroke treatments they desperately need. The most effective stroke treatments are only available if the stroke is recognized and diagnosed within the first three hours of the onset of symptoms. If you think someone may be having a stroke, act F.A.S.T. and do this simple test: F-FACE: Ask the person to smile. Does one side of the face droop? A-ARMS: Ask the person to raise both arms. Does one arm drift downward?

S-SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange? T-TIME: If you observe any of these signs, call 9-1-1 immediately.

For more information, visit McLeodHealth.org.