Saving a Brain From Stroke

When Andrea Viveiros woke up one morning, she knew something was wrong.

“I attempted to pull my hair back and I couldn't raise my right arm," she recalls.

When she was taken to the Rhode Island Hospital emergency department, there was no question—she was having a stroke. However, because she had stroke symptoms when she woke up, the question was when her stroke actually began. Knowing when it began is essential for determining the best treatment.

"If someone wakes up with their symptoms, the vast majority of them, they were last seen normal the night before, so technically they're outside of the fourand-a-half-hour window to be able to safely give them the clot-busting medication," says Shadi Yaghi, MD, co-director of the Comprehensive Stroke Center at Rhode Island Hospital, where Viveiros was taken.

However, a new wake-up protocol at the center can determine that timing. A CT scan confirmed Viveiros was having an ischemic stroke. An MRI then measured tissue damage. "We proved that she's within four-and-a-half hours," Yaghi says. "Andrea was the first patient getting the treatment within this protocol.”

Around 15 to 20 percent of people with stroke symptoms wake up with the symptoms, meaning the stroke could have started hours prior. A typical patient loses 1.9 million neurons each minute a stroke is untreated. The wake-up protocol can save lives by determining a more exact start time of the stroke, and thus, what level of treatment is required.

Thanks to this protocol and the immediate care from the comprehensive stroke center team, Viveiros was back to normal four weeks after her stroke and has taken measures to reduce her stroke risk factors.