Also See: Covenant Health Stroke Check Screenings (05/03) Stroke Risk Factors (05/03) Know the Symptoms of Stroke (05/03) May School of Good Health (05/03) Facilities and Programs: The Patricia Neal Rehabilitation Center - Stroke (CVA) Program Brain Attack and the Covenant Health Stroke Network, by Dr. Eugenio Vargas Covenant Health stroke network formed PT Department Focuses on Stroke Rehabilitation Patricia Neal Rehabilitation Center Physical Therapy at Methodist Medical Center Covenant Health Stroke Information: Healthiest Way Station - Brain Attack Breakthrough Health Information Library: Stroke

"Until a few years ago there was no treatment for stroke. When one occured your crossed your fingers and hoped for the best," said Thomas Higgins, MD, a neurologist with Horizon Physician Group. "But now we have the drug tPA, which is effective for treating certain types of strokes, and there are other clinical investigations underway that offer hope down the road."

Now used as an emergency treatment for stroke, tPA had been primarily used in treating heart attacks to dissolve blood clots blocking arteries. If given within an appropriate "window of opportunity," tPA can restore the flow of blood to the brain before brain cells suffer irreparable damage.

Not all patients are candidates for tPA because there are different types of strokes. But for those who can be helped by tPA, prompt treatment is the key.

"To be effective tPA must be administered within three hours of the onset of symptoms, but diagnostics must be conducted first to see if tPA is the proper treatment," said neurologist Berta Bergia, MD. "So it is important to seek medical help immediately if someone experiences the warning signs of stroke. Optimally, the person should get to the emergency room within the first hour of symptoms."

"There are also a number of other treatments being investigated, including using drugs similar to tPA for dissolving clots as well as administering tPA directly at the site of the clot, which could lengthen the window of opportunity for treatment," Dr. Bergia said. "But these treatments are still in the experimental stage."

Dr. Higgins added, "A clinical trial is being conducted at Fort Sanders Regional Medical Center related to neuro-protective drugs. When a stroke occurs a specific area of the brain can be irreparably damaged, but there is also an area around the stroke site that is in jeopardy. We are investigating the use of neuro-protective drugs to shield the adjacent areas of the brain."

To coordinate efforts in evaluating, treating and rehabilitating stroke patients, the acute care hospitals of Covenant Health formed the Covenant Health Stroke Network in 1997. The network includes emergency room physicians, internists, neurologists, neurosurgeons, radiologists, physiatrists, nurses, EMTs, physical and rehabilitation therapists, and administrators of the five East Tennessee hospital affiliates of Covenant Health: Fort Sanders Regional, Parkwest, Sevier, and Loudon Medical Centers and Methodist Medical Center of Oak Ridge.

The network has sponsored stroke screenings in Knoxville and surrounding areas, provided community education and education for EMS agencies, redesigned treatment protocols for emergency care, developed a collaborative system for triage and transfer of patients from community hospitals to referral centers, and expanded outpatient stroke rehabilitation.

In May, which is National Stroke Month, four of the member hospitals and Covenant Health will sponsor a series of eight free community screenings. (Loudon County residents will have their screening in the fall.). "StrokeCheck" will evaluate risk factors through blood pressure checks, EKGs, blood analyses and carotid bruit screenings (listening for irregularities in blood flow in the carotid artery). The screenings will also provide individual counseling and assessment of stroke risk factors. Participants will receive refrigerator magnets listing the symptoms of stroke.

Since emergency treatment is crucial, you should call 911 immediately is you or someone you love experiences one or more stroke symptoms.

For more information about the stroke screenings, call 541-4500.