Stroke kills approximately 130,000 Americans annually, accounting for one death every four minutes. In the San Joaquin Valley, we face additional challenges. The rate of new strokes in Fresno County is higher than the California average. Additionally, the rate of deaths from stroke in Fresno, Kings, Tulare, Merced and Stanislaus counties is among the highest in the nation.
High blood pressure and obesity, both risk factors for developing stroke, are higher in Fresno County than the state average. These are sobering statistics by any measure. But there is good news as well. The methods used to treat a new stroke these days are more effective than at any time in history.
I am proud to have personally witnessed remarkable improvements in patients that we have had the honor to treat at Community Regional Medical Center. Fresno resident Kay Garabedian is one memorable example.
In the spring of 2014, she experienced sudden left-body weakness and slurred speech while at work. Despite undergoing a rapid evaluation and receiving clot-busting medication at a local emergency room, her symptoms persisted. She was transferred to CRMC for emergency endovascular therapy to restore flow in a blocked major brain artery, and has since made a significant recovery.
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Today she is back at work and participating in all aspects of her life. In years past, such a severe stroke would likely have left her with a severe permanent disability or even death. In many other cases, patients with strokes severe enough to have been fatal or severely disabling instead were able to return home after a brief hospital stay with no significant residual symptoms.
Over the past several years, we have witnessed the emergence of highly effective endovascular stroke therapies (treatments involving physically removing the blockage of a brain blood vessel) in addition to the previously available intravenous therapy (injecting an intravenous “clot-busting” medication).
To date, there have been numerous large studies demonstrating the ability of the newer endovascular treatments, especially in combination with intravenous treatment when possible.
As of 2013, the stroke program at Community Regional has been able to provide this new service to hundreds of patients in the Valley, including those from Fresno, Clovis, Visalia, Tulare, Madera, Merced, Sonora and Hanford.
As the only stroke center in the Valley equipped to perform endovascular treatments, we are proud of the relationships we have built with other area hospitals to rapidly transfer patients to Community Regional if they are eligible for endovascular stroke treatment.
We have the Valley’s only dedicated neurologic intensive care unit and team of neurointensive care physicians and nurses to manage the most complex stroke patients, including bleeding strokes and ruptured brain aneurysms.
Previously, Central Valley patients with complex stroke and ruptured brain aneurysms had to be sent to medical centers hours away, wasting critical time and adding travel expense for loved ones.
We also have more knowledge about what you can do to avoid a stroke than at any time in history.
New research published this year found that 90 percent of strokes can be prevented by modifying several important risk factors.
These include treating high blood pressure, quitting cigarette smoking, avoiding excessive alcohol use, losing weight (for overweight or obese individuals), treating high cholesterol, switching to a diet rich in fish, vegetables, and fiber; engaging in regular exercise, and reducing overall stress levels. Incidentally, regular exercise is itself a proven method to reduce overall stress, while also reducing the risk of both stroke and heart disease in other ways.
We recently recognized the 11th annual World Stroke Day, with communities across the globe raising awareness and promoting education of this serious disease.
Perhaps the single most important thing you should know about stroke is to call 911 as soon as possible if you or someone you love develops stroke symptoms. According to the American Stroke Association, 91 percent of patients who obtain modern stroke treatment within 2 ½ hours have a good outcome. Time is of the essence, and every minute counts.
Dr. Amir Khan is director of stroke for Community Regional Medical Center/UCSF-Fresno.