By: Patricia M. Fernandez, MD. MBA
Neurointerventional Radiologist at DHR Health Neuroscience Institute
Stroke remains a serious healthcare problem during the pandemic. Stroke is the blockage of a cerebral artery that carries oxygen and nutrients to the brain by a clot which results in brain cells death. When this happens, the patient suffers a stroke and symptoms such as not being able to speak or move a limb, loss of sensation, vision loss, or facial droop may be present. In Texas, this is a particularly important problem since stroke is the third leading cause of death among Texans, causing 44.6 deaths per 100,000 people.
Medical treatments for stroke patients intend to re-establish blood flow to the brain before the tissue damage is permanent. The available therapies include the administration of tPA, a medication administered through the vein to dissolve the clot, and mechanical thrombectomy, which is a procedure to remove the clot from the artery. The effectiveness of these treatments is based on their fast administration since the brain cells rapidly die when the blood supply is interrupted. Every minute counts during a stroke and recognizing the symptoms could save a life. Systems of care have been organized to provide timely advanced care to stroke patients. This effort requires coordination between multiple resources including hospitals and EMS. Specialized stroke centers are equipped to provide all effective therapies 24/7.
The COVID-19 pandemic is not the time to neglect stroke symptoms. It is postulated that COVID-19 could increase ischemic stroke risk because of its effects on the cardiovascular system. There is also early data suggesting that a stroke could present itself in younger COVID-19 patients. Despite these facts, the stroke admissions and administration of tPA have declined during the initial months of the pandemic. Perhaps, people’s apprehension‘s to seek medical care during the pandemic has played a major role in delaying treatment due to fears of COVID-19 positive patients spreading the virus.
Hospital protocols have been modified to meet the demands and constraints of stroke care during the pandemic. The aim is to continue to provide care to all patients presenting with stroke symptoms. Most stroke centers assume that patients presenting with an acute ischemic stroke have COVID-19 until it can be excluded and all precautions are implemented to equally provide stroke care without delay and to follow safety guidelines. It is very important to highlight that regardless of the concerns about COVID-19, people having stroke symptoms should not ignore them, even if they are mild or transient. The COVID-19 pandemic has affected many, but stroke centers continue to offer effective care.
During the pandemic, the DHR Health Level I Advanced Comprehensive Stroke Center is prepared to care for both COVID-19 patients having a stroke and stroke patients without COVID-19 in a timely and safe manner. If you need immediate assistance for a stroke, please call 911.