Oak Valley Health’s patient education pages share the skills, knowledge, and habits patients and families need to know to cope with a daily health issue. We hope this information can influence patient behaviour to improve health outcomes and provide you with a sense of control and autonomy.
Learn more about the risks, causes, and treatment of stroke
- A stroke is an injury to a part of the brain and is a medical emergency.
- It may be caused by a blockage of the blood vessel, or by a rupture of the blood vessel in the brain.
- Depending on the area of blockage or rupture, a person will have different symptoms such as difficulty speaking, or moving one side of the body.
- Patients may then be transported to other hospitals that provide emergency stroke treatments.
If your friend or family member has had a stroke caused by a blockage of blood flow to the brain, this type of stroke is called an ischemic stroke. Treatment that may be considered includes:
- A medication called tissue plasminogen activator (tPA). This medication helps to dissolve or break down the clot and restore blood flow to the brain. It is given through an intravenous (IV), a thin tube that is inserted into a vein in the arm. Not everyone will benefit from receiving tPA as it may interact with medications or make some medical conditions worse.
- Endovascular Thrombectomy (EVT) – a procedure to remove the blood clot. To determine if someone will benefit from this procedure, they will have special imaging called computed tomography angiogram (CTA) to look at blood vessels and blood flow in the brain.
A small thin tube, called a sheath, is inserted in the femoral artery in the groin area.
A guide wire and catheter are inserted through the sheath into the femoral artery and passed to the artery with the clot in the brain.
The guide wire is removed and a compressed mesh stent is inserted through the catheter to the clot.
The catheter is pulled back causing the mesh stent to expand through the clot. Once the clot is “trapped” in the stent, the clot can be safely removed with the stent.
Patients that arrive at their community hospital within 4 hours from when their stroke symptoms first appear will be assessed as candidates for tPA and EVT, and potentially be transported to the closest, designated stroke centre i.e. Cortellucci Vaughan Hospital
from Markham Stouffville Hospital or Lakeridge Health Oshawa from Uxbridge Hospital.
Patients that arrive at their community hospital within 4-24 hours from when their stroke symptoms first appear will be assessed as candidates for EVT and potentially transported to a designated EVT centre in Toronto i.e. Sunnybrook Health Sciences Centre, St. Michael’s Hospital, or Toronto Western Hospital.
A specialized stroke team completes the assessment at the designated stroke centre. Not all patients that are transported will be suited for treatment once they arrive. The decision is made by specialized doctors at the stroke centre who will balance the potential benefit and risk for each patient.
- Patients who receive tPA or EVT will be admitted to the specialized stroke centre for approximately 24-48 hours. Patients will return to a hospital closer to home when they are medically stable and suitable for transfer.
- If it is determined that the patient will not benefit from tPA or EVT treatment, the patient will return to the originating hospital or will be transferred to a hospital closer to home where they will still receive stroke care in the form of medicines and rehabilitation.
- If at all possible, the person with Power of Attorney for Personal Care or the Substitute Decision Maker should keep their phone handy. The stroke centre hospital may call them to provide consent for treatment.
- The person with Power of Attorney for Personal Care or the Substitute Decision Maker may be allowed to travel with the patient during transfer or they may travel to the designated stroke centre hospital in their own vehicle. Please speak to the care team to determine what kind of arrangement is possible.