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February 14, 2011
HEALTH & LIFESTYLES NEWS FROM FORT SANDERS REGIONAL MEDICAL CENTER
Stroke treatment at Fort Sanders saves Maryville woman In the spring of 2007, Lori McKinney of Maryville noticed that as she typed at her computer, her left hand didn’t work well. “I also had decreased vision in my left eye, slurred speech on my left side and weakness in my left arm,â€? McKinney remembers. “I just ignored it. I was really afraid it was a brain tumor.â€? Then, on May 10, 2007, McKinney got a terrible headache as well. “I was at home at the time and didn’t go to work. Over the next few days, I had increasing problems.â€? At the urging of her husband, Jim, McKinney ďŹ nally made an appointment with her primary care doctor. The exam found her blood pressure was dangerously high, and a CT scan revealed a spot on her right brain. A follow-up MRI revealed the spot was not a tumor as she feared, but a stroke caused by a blockage. Like heart arteries, brain blood vessels can build up plaque that restricts the ow of blood and causes a stroke. Strokes are either caused by blockages or bleeds. With a bleed, a blood vessel bursts in the brain and damages the tissue around it. Strokes are the third leading cause of death in the United States. Although most stroke victims are older than 65, McKinney was just 43 at the time. “That was really scary,â€? she says. Within a week, McKinney was referred to Dr. Keith Woodward, a neurointerventional radiologist who treats strokes at Fort Sanders Regional Medical Center. Dr. Woodward is one of only 300 physicians in the United States who is able to do a minimally-invasive procedure to treat strokes called intracranial angioplasty. In this procedure, a tiny balloon is threaded through an artery in the groin, up to the brain and the area of blockage. The balloon is
Every minute counts when a stroke strikes: Get to a Primary Stroke Center fast
Social worker Lori McKinney is back on the job after a high tech treatment for stroke at Fort Sanders helped her get her life back. then expanded to force accumulated fatty plaque against the artery wall, opening the blood vessel. Intercranial angioplasty can be done with or without a “stent.â€? A stent is a tiny wire coil left behind to keep the artery propped open. McKinney couldn’t have a stent, she says, because Dr. Woodward felt it would be too dangerous. Both types of brain angioplasty are done with the beneďŹ t of stateof-the-art imaging machines at Fort Sanders, which take continuous CT images that give the physician an accurate 3-D picture of the brain throughout the procedure. Intracranial angioplasty has a short hospitalization and is considered minimally invasive. “I went from 99 percent blockage overall, to 60 percent ow,â€? says McKinney. A second angioplasty in
August 2007 increased the ow of blood to her brain even more. McKinney, a social worker, missed six months of work throughout the ordeal, but is fully recovered now after some physical and speech therapy. McKinney says she felt conďŹ dent in Fort Sanders and in Dr. Woodward. “I can’t say enough about Dr. Woodward,â€? smiles McKinney. “He said, ‘You’re just an incredible miracle.’ I said, ‘Well, I had a whole lot of help. I give a lot of glory to the Lord.’ â€? McKinney says she is thankful for Fort Sanders and its ability to offer such a state-of-the-art treatment for strokes. “It was wonderful, absolutely wonderful,â€? McKinney says of her care at Fort Sanders. “From the time I got here until the time I left four days later, it was excellent.â€?
Stroke is the third leading cause of death in the United States and the No. 1 cause of disability in adults. Strokes affect more than 600,000 Americans every year. A stroke is basically a “brain attack.â€? It happens when the blood ow to an area of the brain is interrupted by a blocked or broken blood vessel. When a stroke occurs, it kills brain cells in the immediate area and endangers cells in surrounding brain tissue. Without immediate medical treatment, a larger area of your brain may die and you may suffer permanent brain damage, paralysis, speech impairment or even death. Symptoms of stroke may include: weakness of the face or arm on one side of the body, loss of vision and a sudden severe headache. As a Primary Stroke Center, Fort Sanders Regional is equipped to handle stroke from the initial diagnosis, to the treatment and through the rehabilitation process. When patients suspected of having a stroke comes to Fort Sanders Regional, they receive a CT scan within 45 minutes. If they arrive within three hours of the onset of the stroke, the patient will receive powerful clot-busting drugs (called thrombolytics) that can open blocked arteries and reduce the effects of stroke. For patients who arrive in the emergency room after three hours, thrombolytics can be administered directly into the clot through a small catheter that goes up the patient’s leg into in the blocked artery in their brain. A corkscrew device, called the Merci clot retriever, can be inserted through a catheter to remove a
clot to restore normal blood ow to large arteries in the brain. As a Stroke Center of Excellence, the care provided by Fort Sanders Regional and Patricia Neal Rehabilitation Center (located inside Fort Sanders) is second to none. The facility is one of the few in Tennessee to hold a Primary Stroke Center certiďŹ cation from the Joint Commission, as well as three separate stroke accreditations from the Center for the Accreditation of Rehabilitation Facilities (CARF). Stroke survivors have complex rehabilitation needs. Brain injury resulting from stroke can affect speech and memory. Temporary or long-paralysis on one side of the body can also occur. The nationally-recognized rehabilitation programs at Patricia Neal Rehabilitation Center help stroke patients restore abilities and regain lost capacity. Fort Sanders and Patricia Neal have achieved such designations by having a committed medical team, excellent nursing and therapy services, and stateof-the-art diagnostics, treatment and rehabilitation. For further information about stroke treatment and rehabilitation at Fort Sanders Regional and Patricia Neal Rehabilitation Center, call 865-673-FORT.
Neuro Science Center of Excellence at Fort Sanders: Innovative treatment for strokes and aneurysms and repair aneurysms. Keith Woodward, M.D., is a certiďŹ ed neurointerventional radiologist at Fort Sanders Regional. He is one of the few physicians in the United States who uses the bi-plane technology to seal off an aneurysm. He does this by coiling a tiny platinum wire into the weakened blood vessel in the brain. Dr. Woodward also uses the bi-plane to help him retrieve blood clots from the brain with a small corkscrew device. Restoring blood ow quickly can often reverse the effects of a stroke. Both procedures are done less invasively through a tiny catheter inserted by a needle stick in the groin area. Patients experience a smaller
amount of pain, a shorter hospital stay and a quicker recovery. “It’s exciting to be able to treat major diseases of the blood vessels in the brain without major surgery,� says Dr. Woodward. Not all patients can be treated with these techniques. In some cases, traditional neurosurgery may be recommended. Fort Sanders neurointerventional radiologists and neurosurgeons work together to determine the best treatment for each individual patient. For more information about the treatment of stroke and aneurysm at Fort Sanders Regional, call 3-D images produced by an advanced Bi-Plane Angiography system help 673-FORT (3678) or visit our web- neurointerventional radiologist Dr. Keith Woodward reverse the effects of site at fsregional.com. many strokes and aneurysms.
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In the past, procedures to repair weakened or abnormal blood vessels in the brain have required invasive brain surgery that involved opening the patient’s skull. Recovery often took weeks or months. Now, with the region’s most advanced Bi-Plane Angiography system, physicians of the Neuro Science Center of Excellence at Fort Sanders Regional are using lessinvasive measures to treat dangerous aneurysms and strokes. Fort Sanders’ innovative BiPlane 3-D x-ray offers two independent views that show a detailed picture of the blood vessels in the brain. This helps physicians to more accurately reverse strokes