William Boudouris, D.O., likes to use the phrase brain attack when talking about strokes. The reason: The words stress just how serious strokes are. “Like heart attacks, brain attacks are medical emergencies,” says Dr. Boudouris, who is chairman of Botsford Hospital’s Neurology Department and director of Botsford’s Stroke Center. “There are so many times I hear, ‘My symptoms started last night but I thought they’d go away, so I waited,’” he says. “By then, it’s too late for some interventions.”
Botsford treats about 200 patients a year for stroke and is well-equipped to do so. So much so that it’s certified as a primary stroke center (see below). What that means is the hospital is prepared to accept, evaluate, and treat stroke emergencies 24 hours a day, 7 days a week. Then, when the patient is ready for rehabilitation, Botsford offers programs and support groups that can substantially help patients achieve the best possible outcomes.
Why is time so important for someone having a stroke? One reason is because some therapies are time-sensitive, including a medication called tissue plasminogen activator, or tPA. TPA dissolves blood clots that are blocking blood flow to the brain. To be effective, tPA must be given within three hours after a stroke starts. That means patients must arrive at the hospital soon after symptoms start in order to allow time for evaluation and treatment.
If tPA isn’t an appropriate treatment, others are available—but time matters for them as well. “Basically, if someone shows signs of a stroke, it’s an emergency,” he says. “The sooner you get to the hospital, the better your prognosis.”
What is a Stroke?
There are two major types of strokes:
About 80 percent of strokes are ischemic and 20 percent are hemorrhagic, according to the National Institute of Neurological Disorders and Stroke. Strokes rob the brain of blood and nutrients, and when that happens brain cells start to die. The results can range from mild to devastating, affecting speech, movement, thinking, and emotions. Permanent paralysis and death are possible—in fact, more than 4,4000 people in Michigan died from stroke in 2010, according to the Centers for Disease Control and Prevention.
Lowering your risk
Of course, the best scenario is to prevent strokes altogether, Dr. Boudouris stresses. Some risk factors can’t be changed, like age and family history, but there are many ways to reduce your risk for strokes, including these:
A healthy, low-fat diet, regular exercise, and taking medications if needed are fundamental lifestyle changes that can dramatically improve health and lower the risk of stroke. “Work with your doctor, set goals, and follow up regularly,” Dr. Boudouris says. “Prevention is really what we’re after.”
Botsford earns status as primary stroke center
Botsford Hospital has earned certification as a primary stroke center from the national Healthcare Facilities Accreditation Program. What that means is Botsford meets the high standards that support better outcomes in stroke patients. "It's a very rigorous process," says William Boudouris, D.O. "They looked at our data, our benchmarks, how patients are triaged, how quickly patients get through the emergency room, how quickly they get a CT scan."
Botsford's medical and support staff also had to show that it could stabilize and treat acute stroke patients and administer the clot- busting medicine tPA and other acute therapies safely and efficiently.
"All said, we really haven't changed the way we do things. The accreditation just gives us recognition," says Dr. Boudouris "What it also does, though, is let our community know we are committed to excellence."