Stroke Center

Ingalls Stroke Center

Nationally recognized stroke care at Ingalls

Stroke is the third leading cause of death in the United States, claiming nearly 700,000 lives every year. It is also one of the leading causes of disability among American adults. The good news is that stroke can be prevented. In fact, according to the National Stroke Association, up to 80% of strokes are preventable.

That's why Ingalls has committed significant resources to increasing awareness of stroke symptoms and prevention through its nationally recognized Stroke Center of Excellence. By educating the community about the risk of stroke – and helping individuals take action to minimize those risks – more lives will be spared from this devastating disease.

Gold Seal of Approval

In February 2008, the Ingalls Stroke Center earned the Gold Seal of Approval™ from the DNV for Primary Stroke Centers. The commendation demonstrates that Ingalls' stroke care program follows stringent national standards and guidelines that can significantly improve outcomes for stroke patients, according to the DNV.

Stroke care at Ingalls is part of our nationally recognized Neurosciences program, which has earned Ingalls the distinction as one of "America's Top Hospitals" by U.S. News & World Report, eight years running, from 2002-2009.

Ingalls Stroke Center of Excellence

Ingalls developed its Stroke Center in 2006 to increase awareness of stroke symptoms and prevention – and to diagnose and treat stroke patients as quickly as possible. Under the medical direction of board-certified neurologist Engin Yilmaz, M.D., the Stroke Center integrates the services of the Emergency Department, Nursing, Radiology, Laboratory, Pharmacy and Rehabilitation. This multi-disciplinary approach to stroke management covers all aspects of stroke care, from prevention and diagnosis to acute care and rehabilitation. What's more, an interdisciplinary Stroke Team meets on a monthly basis to review stroke performance improvement, quality measures, treatment protocols, clinical practice guidelines and the education of stroke patients, the community and staff. The Stroke Team is led by a dedicated Stroke Program Coordinator, Deborah Lawrence, MS, ACNS-BC, APN.

As part of its dedicated Stroke Center, Ingalls developed and implemented a stroke protocol according to American Stroke Association guidelines and recommendations to ensure that stroke patients are diagnosed and treated as quickly as possible. The protocol includes the immediate availability of a CT scan within minutes of a patient's arrival at the Emergency Department, and administration of clot-busting drugs in selected patients.

In addition to emergent and acute inpatient care for stroke patients, Ingalls offers a full continuum of care, including rehabilitation and support both on an inpatient and outpatient basis.

  • Understanding Stroke

    A stroke (also called a "cerebrovascular accident") occurs when blood vessels carrying oxygen and other nutrients to a specific part of the brain suddenly burst or become blocked. When blood fails to get through to the affected parts of the brain, the oxygen supply is cut off, and brain cells begin to die.

    Strokes fall into several major categories, based on whether the disrupted blood supply is caused by a blocked blood vessel or a hemorrhage. Since each type of stroke has a different type of treatment, it is very important for the physician to determine the cause of the stroke, as well as the location, as quickly as possible.

    Ischemic Stroke

    Ischemic stroke results from a blocked blood vessel, either within an artery in the brain (thrombotic stroke), or in another artery within the body, and the clot or blockage breaks loose and travels to the brain (embolic stroke). Thrombotic is the most common type of ischemic stroke, with a blood clot forming inside an artery in the brain, blocking blood flow. Sometimes, the clot occurs in one of the neck arteries (carotid or vertebral) that transport blood from the heart to the brain. Blood clots form most often in arteries damaged by atherosclerosis, a disease in which rough, fatty deposits build up on the walls of the arteries and project into the bloodstream. These deposits gradually narrow the passageway, causing the blood flow to slow down and, sometimes, to completely occlude (block) the artery.

    Hemorrhagic Stroke

    The other main category of stroke, hemorrhagic stroke, occurs when a blood vessel in or around the brain ruptures, spilling blood into the brain or the area surrounding the brain. When this occurs, the cells nourished by the artery fail to get their normal supply of nutrients and cease to function properly. Furthermore, the accumulated blood from the ruptured artery soon clots, displacing normal brain tissue and disrupting brain function. Cerebral hemorrhage is most likely to occur in people who suffer from a combination of atherosclerosis and high blood pressure.

    Stroke Warning Signs

    (If symptoms appear, call 911 to get immediate medical help)

    • Sudden weakness, numbness or paralysis of the face, arm or leg (especially on one side of the body)
    • Loss of speech or trouble talking or understanding language
    • Sudden loss of vision, particularly in one eye
    • Sudden, severe headache with no apparent cause
    • Unexplained dizziness, loss of balance or coordination (especially if associated with any of the above symptoms)

    Transient Ischemic Attacks (TIAs)

    About one-third of all strokes are preceded by one or more "mini-strokes," known as transient ischemic attacks (TIAs). TIAs can occur days, weeks or even months before a stroke.

    TIAs occur when a blood clot temporarily clogs an artery, and part of the brain doesn't get the blood it needs. The symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes. The average is about a minute. Unlike stroke, when a TIA is over, there's no injury to the brain.

    TIAs are extremely important predictors of stroke. Don't ignore them! If symptoms appear, call 911 to get immediate medical help. A doctor should determine if a TIA or stroke has occurred, or if it's another medical problem with similar symptoms. Prompt medical or surgical attention to these symptoms could prevent a fatal or disabling stroke from occurring.

  • Stroke Risk Factors

    What risk factors for stroke can't be changed?

    Age — The chance of having a stroke approximately doubles for each decade of life after age 55. While stroke is common among the elderly, a lot of people under 65 also have strokes.

    Heredity (family history) and race — Your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke. African-Americans have a much higher risk of death from a stroke than Caucasians do, partly because blacks have higher risks of high blood pressure, diabetes and obesity.

    Sex (gender) — Stroke is more common in men than in women. In most age groups, more men than women will have a stroke in a given year. However, more than half of total stroke deaths occur in women. At all ages, more women than men die of stroke. Use of birth control pills and pregnancy pose special stroke risks for women.

    Prior stroke, TIA or heart attack — The risk of stroke for someone who has already had one is many times that of a person who has not. Transient ischemic attacks (TIAs) are "warning strokes" that produce stroke-like symptoms but no lasting damage. TIAs are strong predictors of stroke. A person who's had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn't. Recognizing and treating TIAs can reduce your risk of a major stroke. If you've had a heart attack, you're at higher risk of having a stroke, too.

    What stroke risk factors can be changed, treated or controlled?

    High blood pressure — High blood pressure is the leading cause of stroke and the most important controllable risk factor for stroke.

    Cigarette smoking — The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways. The use of oral contraceptives combined with cigarette smoking greatly increases stroke risk.

    Diabetes mellitus — Diabetes is an independent risk factor for stroke. Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight. This increases their risk even more. While diabetes is treatable, the presence of the disease still increases the risk of stroke.

    High blood cholesterol — People with high blood cholesterol have an increased risk for stroke.

    Physical inactivity and obesity — Being inactive, obese or both can increase your risk of high blood pressure, high blood cholesterol, diabetes, heart disease and stroke. Try to get a total of at least 30 minutes of activity on most or all days.

    Carotid or other artery disease — The carotid arteries in the neck supply blood to the brain. A carotid artery narrowed by plaque buildups in artery walls may become blocked by a blood clot.

    Peripheral artery disease — PAD is the narrowing of blood vessels carrying blood to leg and arm muscles, caused by fatty buildups of plaque in artery walls. People with peripheral artery disease have a higher risk of carotid artery disease, which raises their risk of stroke.

    Atrial fibrillation — In this heart rhythm disorder, the heart's upper chambers quiver instead of beating effectively, which can let the blood pool and clot. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results.

    Other heart disease — People with coronary heart disease or heart failure have a higher risk of stroke than those who don't. Dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects also raise the risk of stroke.

    Sickle cell disease (also called sickle cell anemia) — This is a genetic disorder that mainly affects African-American and Hispanic children. Sickle-shaped red blood cells are less able to carry oxygen to the body's tissues and organs, and also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke.

    Poor diet — Diets high in saturated fat, trans fat and cholesterol can raise blood cholesterol levels, while diets high in salt can contribute to increased blood pressure. A diet containing five or more servings of fruits and vegetables per day may help reduce the risk of stroke.

  • Stroke Prevention

    The Ingalls Stroke Center is actively recruiting participants for a landmark research study aimed at preventing recurrent stroke or heart attack in individuals who have had a recent stroke or transient ischemic attack (TIA).

    Ingalls is the only hospital in the South Suburbs – and one of only 100 hospitals nationwide – to participate in the Insulin Resistance Intervention after Stroke or TIA (IRIS) clinical trial. IRIS will enroll more than 3,000 patients from major health centers throughout the world.

    Sponsored by the National Institute of Neurological Disorders and Stroke, IRIS will determine if a diabetes medication called pioglitazone (brand name Actos) will help reduce insulin resistance and prevent future stroke or heart attack in non-diabetic patients.

    Over time, insulin resistance may lead to atherosclerosis, the same blood vessel disease that causes most strokes and heart attacks. Despite current treatments, 25% of stroke or TIA patients will have a subsequent stroke or heart attack within five years. Preventing these events is a major goal of the study.

    According to the National Institutes of Health, half of all stroke or TIA patients have insulin resistance. Scientists believe that treating this condition with pioglitazone may help prevent stroke and heart attack.

    When diabetics take pioglitazone, insulin resistance is reduced and blood sugar improves. Right now, medications like pioglitazone are not used to treat insulin resistance unless a patient is already diabetic. IRIS will test if pioglitazone has a similar benefit in non-diabetic patients.

    Surgical Techniques to Prevent Stroke

    Surgery may be used to prevent stroke for patients with certain conditions.

    Carotid Endarterectomy

    Carotid endarterectomy is a procedure used to remove atherosclerotic plaque from the carotid artery when this vessel is blocked. It has recently been proven that for certain patients with minor strokes or TIAs, carotid endarterectomy is highly beneficial in preventing future strokes. This procedure is also beneficial for some patients with blockage of the carotid arteries who have not had previous symptoms.

    Stenting of Vessels in the Neck

    Stenting of vessels in the neck is a newer procedure offered at a few select hospitals in the area, including Ingalls. Stenting of carotid arteries involves the use of a fine, tubular wire mesh to hold the vessel open.

  • Superior Rehabilitative Services

    The Ingalls Center for Rehabilitative Medicine was the first in the State of Illinois to receive a three-year stroke specialty accreditation by the prestigious Commission on Accreditation of Rehabilitation Facilities (CARF). Overall, the center scored in the top three percent of all CARF surveys nationwide.

    Recognized by physicians for its superior care, the 53-bed inpatient unit serves as a regional referral center, accepting patients from hospitals throughout Chicago's South and Southwest suburbs. Acute rehabilitation is offered in five primary areas: amputee, general, neurological, orthopedic and stroke. The center offers 24-hour nursing care by specially trained rehabilitation nurses and the services of full-time physiatrists (physicians who specialize in physical medicine and rehabilitation).

    The unit also offers on-site physical, occupational and recreational therapy, as well as speech therapy or neuropsychology at the rehabilitation physician's order. Ongoing education for patients and families, and stroke support groups are also available to all stroke patients through Ingalls.

    Ingalls also offers outpatient rehabilitative services through the Ingalls Center for Outpatient Rehabilitation (ICOR) in Calumet City – and at Ingalls Family Care Centers in Flossmoor and Tinley Park.

    Physicians & Staff - A Team Approach to Patient Care

    During their hospital stay at Ingalls, stroke patients receive superior care from a dedicated, interdisciplinary team that includes:

    • Physicians - the patient's primary care physician, as well as a variety of specialists, including neurologists, neurosurgeons, radiologists, anesthesiologists and physiatrists.
    • Registered Nurses - who assess and coordinate patient needs, administer treatment, and provide patient/family instruction.
    • Nursing Assistants - who provide personal care and hygiene.
    • Physical, Occupational and Speech Therapists – who provide individualized rehabilitation treatment.
    • Social Workers – who offer support to patient and family and coordinate appropriate community resources.
    • Chaplains – who offer spiritual support to patient and family.
    • Case Managers – who oversee hospitalization; coordinate with insurance payors; and work to insure follow-up arrangements such as home care.
    • Dietitians – who assist with proper design of nutritional and caloric intake.

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