June is Stroke Month
The Neuro is an important centre for stroke care in Montreal
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The Montreal Neurological Institute (The Neuro) is marking Stroke Month in June to increase public awareness about the dangers of this serious condition, and the importance of early intervention. A Canadian suffers a stroke every ten minutes. Each year, about 14,000 Canadians die of stroke, making stroke the third-leading cause of death in this country.
In 2015, The Neuro was designated as a tertiary stroke centre, only the second such centre in Montreal. Since then, The Neuro鈥檚 special stroke Receiving Area (RA) has provided rapid care to many hundreds of patients. The RA continues to refine its services to ensure that patients receive optimum care.
鈥淭he sooner that a patient gets the right intervention at the right time and right place, the better the outcome,鈥� says Rosa Sourial, clinical nurse specialist at the RA.
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New direct access to stroke Receiving Area
Last year, Quebec鈥檚 Health Ministry issued 鈥渓e Cartable AVC,鈥� a directive that outlines the trajectory of stroke patients from pre-hospital to acute care.
鈥淪ince October 15, ambulances can bring the patient immediately from home to a tertiary stroke centre like The Neuro鈥檚,鈥� says Sourial. 鈥淚f ambulance technicians determine that the patient has three-out-of-three symptoms on the Cincinnati score, then they can alert us that they are on their way.鈥�
The Cincinnati score involves an evaluation of a patient on three counts: drooping face, slurred speech, and weakness in an arm or leg. Patients with a three-out-of-three score may be transported from home directly to The Neuro with a call from Urgences Sant茅 to the RA.
The guiding principle in the Health Ministry directive lies in the 鈥渞ight intervention鈥� policy. The right intervention can be a thrombectomy, which is the removal of clots (thrombi) in a blood vessel in the brain.
鈥淪ince October, we鈥檝e had an increase in the number of RA patients who had thrombectomies,鈥� says Sourial. 鈥淭his procedure is performed by our two interventional neuro-radiologists, Dr. Donatella Tampieri and Dr. Maria Del Pilar Cortes Nino.鈥�
Indeed, the number of patients entering the RA increased significantly in the past year compared to the previous year. In the 12-month period starting April 1, 2015 and ending March 30, 2016, the RA saw 866 patients. In the same period for 2016-2017, the number grew to 1,195.
Following the thrombectomy, some patients will be transferred to a secondary stroke centre in a hospital in an area determined by the 鈥淐artable AVC.鈥� The patient can be repatriated within 24 hours, a process that requires coordination and organization between the secondary stroke centre (CH2) and the tertiary stroke centre (CH3.) Sourial admitted that the logistics of patient repatriation are still being perfected.
鈥淲e and our partners are all involved and motivated for its success for the well-being of our patients.鈥�
The Neuro鈥檚 RA activity will increase still more this Fall when the Montreal General Hospital secondary stroke unit moves ten stroke beds to The Neuro.
鈥淲e鈥檒l become both a secondary and tertiary stroke centre unit,鈥� says Sourial.
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Stroke care at The Neuro
Both inpatient and outpatient treatment for stroke are provided at The Neuro.
The Neuro鈥檚 stroke specialists:
Dr. Donatella Tampieri directs The Neuro鈥檚 Department of Diagnostic and Interventional Neuroradiology. A leading authority and practitioner of interventional neuroradiology, Dr. Tampieri handles acute stroke treatment, brain revascularization, endovascular treatment of intracranial aneurysm, arterio-venous malformations, dural arterio-venous fistula and pre-operatory embolization of tumours. She devotes much of her clinical activity to treating back and cervical spine pain such as nerve and facets block, epidural injections, and vertebroplasty. In 2016, the Quebec Federation of Medical Specialists (F茅d茅ration des m茅decins sp茅cialistes du Qu茅bec), an umbrella organization embracing medical specialist groups in the province, awarded its Prix d鈥檈xcellence en innovations des soins de sant茅 to Dr. Tampieri in recognition of her exceptional career in providing quality healthcare that is accessible, efficient, and safe.
Dr. Jeanne Teitelbaum, a neurologist and neuro-intensivist, is Director of Stroke Service. Her specialty lies in acute stroke treatment and neurological critical care.
Dr. Maria Del Pilar Cortes Nino is a specialist in neuro-interventional and diagnostic neuroradiology. She performs spinal percutaneous injections and diagnostic procedures related to stroke.
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What is a stroke?
When natural blood flow to the brain is disrupted for whatever reason, a stroke can occur.听By far, the most common such event is an ischemic stroke, which is an interruption in blood flow.听There are also hemorrhagic strokes in which a blood vessel in the brain ruptures.听
Tiny strokes are termed Transient Ischemic Attacks (TIA) whose effects are negligible. Nonetheless, a TIA should be considered as a warning.听 Following a TIA, a person is five times more likely to have a stroke within two years.
The extent of damage in the brain due to a stroke depends on the brain region that was affected and on the length of time that the event occurred.听It is essential, therefore, that medical treatment be applied as quickly as possible.听 In the case of an ischemic stroke, a victim who receives drug treatment within three or four hours of the event can reduce the extent of potential brain damage significantly.
A stroke victim can expect to recover fully from a minor stroke, but major strokes can have serious effects. As a consequence of a major stroke, victims might be unable to speak, read, write, recall events, or to move normally.
Here are the main warning signs of stroke:听 weakness, speech or vision problems, severe headaches, dizziness leading to disequilibrium.听Should you experience these symptoms, you should consider seeing a doctor.
The main risk factor for stroke is high blood pressure (hypertension). One out of five Canadians has high blood pressure.
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The Neuro
The Montreal Neurological Institute and Hospital 鈥� The Neuro 鈥� is a world-leading destination for brain research and advanced patient care. Since its founding in 1934 by renowned neurosurgeon Dr. Wilder Penfield, The Neuro has grown to be the largest specialized neuroscience research and clinical centre in Canada, and one of the largest in the world. The seamless integration of research, patient care, and training of the world鈥檚 top minds make The Neuro uniquely positioned to have a significant impact on the understanding and treatment of nervous system disorders. In 2016, The Neuro became the first institute in the world to fully embrace the Open Science philosophy, creating the Tanenbaum Open Science Institute. The Montreal Neurological Institute is a 91社区 research and teaching institute. The Montreal Neurological Hospital is part of the Neuroscience Mission of the 91社区 Health Centre. For more information, please visit听
