Stroke

A Message From Our Medical Director

Welcome to GHS Stroke Center. We are dedicated to providing the best quality stroke care in the Upstate of South Carolina. In sharing and adopting from Trauma (Surgery) and STEMI (Heart and Vascular Institute) our team consists of many providers with a wide range of expertise. We have been certified by the Joint Commission as a Primary Stroke Center since 2009. We have maintained Gold –Plus and Target Stroke performance with American Heart Association's Get With the Guidelines.  We have seen a steady growth in the patients and families we care for over the past five years.

I can recall learning about stroke almost 25 years ago. There are fundamentally two types of stroke: ischemic and hemorrhagic. By far the large majority of strokes are ischemic at 87%, and the remainder is hemorrhagic at 13%.  Treatment options have evolved significantly, however there is a long way to go. Intravenous thrombolysis for acute ischemic stroke was proven effective in December 1995 and FDA approved in 1996. With this, the stroke thrombolysis era was launched. The Brain Attack Coalition proposed the development of Primary Stroke Centers in 2000 and the first centers were certified in the fall of 2003. Currently there are about one thousand Primary Stroke Centers in the United States. South Carolina is in the heart of the Stroke Belt and has over 15 Primary Stroke Centers.

Our treatment rates for acute ischemic stroke with thrombolysis, also known as TPA, are at about 20% which is almost double the national average. We consistently meet or exceed the goal for door to treatment times, less than 60 minutes, for TPA. There is still more work to be done including stroke awareness, and Time is Brain, that is, the more time the part(s) of your brain go without oxygen and nutrients the more neurons and supporting brain structures will die.

For aneurysmal subarachnoid hemorrhage the advancements in endovascular coiling have grown considerably since 1991. Currently at many centers world-wide endovascular aneurysm care has outpaced open surgical clipping via craniotomy. Advances like this have actually led to more innovative ways to care for cerebral aneurysms which may incorporate individual or combination therapies to secure cerebral aneurysms ruptured or un-ruptured.

Stroke care now involves primary and secondary prevention, acute stroke care, rehabilitation, education and research. Stroke awareness has grown considerably beginning with the most fundamental element of recognizing stroke signs and symptoms, and to call 911/EMS. So remember to act FAST (Face-Arm-Speech-Time) if you or a loved one may be experiencing a stroke and call 911.

As a Certified Primary Stroke Center we are expected to share our expertise with other facilities in a timely fashion in providing acute stroke care. We are encouraged to learn that the designation of Acute Stroke Ready Hospitals is on the horizon and will target hospitals which are more rural in location and may not have on site Neurology coverage. The goal here is Telemedicine by which twenty-four hour access to Emergency Neurology coverage will be available. Regardless of hospital designation we are optimistic that the level of stroke care will continue grow and we can work on preventative efforts to reduce stroke incidence.

For the future we are planning to become a Joint Commission Certified Comprehensive Stroke Center. This was described by the Brain Attack Coalition in 2005. With the formation of a Neuroendovascular Surgical Team and the creation of a dedicated Neuroscience Intensive Care Unit lead by Dr. Sharon Webb, we are optimistic in achieving our goals. With the opening of the South Carolina School of Medicine Greenville Campus, we are looking forward to greater opportunities for scholarly research.

I would like to thank all of the participants in stroke care at GHS including EMS and the Stroke Survivors. We must continue to raise stroke awareness in the region and the state.

Thank you,

Rodney Leacock, MD
Interim Stroke Center Medical Director

Shannon Sternberg, RN, MSN, CNRN, SCRN
Stroke Center Manager