How to Spot Stroke Symptoms

Time is of the essence for someone experiencing a stroke. Dr. Martin Radvany, Chief of Interventional Neuroradiology at UAMS, discusses stroke symptoms and treatment.
How to Spot Stroke Symptoms
Featured Speaker:
Martin Radvany, MD
Marvin Radvany, M.D., an internationally known leader in interventional neuroradiology and specialist in vascular disorders of the brain and spine, has joined the Department of Radiology as Professor and Chief of Interventional Neuroradiology. 

Learn more about Martin Radvany, MD
Transcription:
How to Spot Stroke Symptoms

Evo Terra (Host): When I was a teenager many, many decades ago, my great grandfather suffered a debilitating stroke which confined him to a managed care facility—we called them nursing homes back then—for the remainder of his days, which unfortunately were far too few. But that was 40 years ago. Today I’ll talk with Dr. Martin Radvany, chief of interventional neuroradiology at UAMs to discuss how comprehensive stroke centers have changed the lives of those who were experiencing a stroke. This is UAMS Health talk, the podcast from the University of Arkansas for Medical Sciences. I'm Evo Terra. Dr. Radvany, perhaps you can give me an overview of the sweeping changes I'm sure you’ve seen during your years of practice in the treatment of strokes.

Martin Radvany, MD (Guest): There has been quite an evolution in how stroke is treated in the last decade. When I first started treating stroke, the tools we had were pretty crude. We could put a small tube up into the blood vessel next to the blockage and try and infuse a medication in there to dissolve the clot, or we had some very crude tools where we could try and pull these clots out. Unfortunately, they were not that effective. Then over time, the tools have really developed quite a bit in the last decade that allow us to very effectively now go up and treat patients who are suffering from blockages of their arteries and their brain. We’re able to actually go up there very quickly, and in most cases we’re able to pull out the clot and restore blood flow to the brain.

Host:   So that’s a very big difference from then and now. What does the future hold for that? What advancements are on the horizon for treating strokes?

Dr. Radvany:  I think some of the things—We can't always get the clot out. Sometimes the clot is just so hard it’s stuck in the blood vessel like a cork. No matter what we have, what we do, we just can't pull it out. So there is work being done on tools that will allow us to remove these clots that are much harder and more difficult right now that we can't take out.

Host:   So in my family, we have a history of lots of clogged arteries in both sides of my family, unfortunately. I, as a 51 year old male, am looking at those things in the future. How would I know if I were having a stroke, or how would someone around me identify if I was actually having a stroke?

Dr. Radvany:  There's been an acronym that’s developed called BE FAST. It’s to help people remember what the signs and symptoms are. So the B is for balance. If a person has a sudden loss of balance or coordination. E is for eyes. Does the person suddenly have blurred or double vision or some persistent problem seeing. F is for face. If you ask the person to smile, if one or both sides of their face are drooping, that’s another sign. Then the A is for arm. So you ask the person to raise both arms. If one arm starts drifting downward or there’s weakness on one side of the body, that’s also a sign of the stroke. The S is for speech. So if you ask someone to repeat a simple phrase and their speech is garbled, you can't understand them, that’s the S. So balance, eyes, face, arm, speech. Then the T is for time because time is of the essence for stroke. So as soon as you see or suspect somebody of having a stroke, it’s imperative that you call 911 also noting when these symptoms began.

Host:   What's my prognosis if that happens? If someone identifies this happening with me and they do call 911 and I get to a hospital, what’s my quality of life going to be like post-stroke?

Dr. Radvany:  Your quality of life is really determined by how long it takes for the strong to be diagnosed and then treated. That’s why I can't overstate how important that T is as far as the time factor. We know that for every 15 minute delay in initiating treatment for a patient who is having a stroke, their chance of a good outcome or a good quality of life decreases.

Host:   Wow. 15 minutes.

Dr. Radvany: For every 15 minutes. So that’s why we rush. When we get a—When our stroke team gets activated, we get to the hospital as quick as we can. Our goal is to have that patient literally upstairs in the operating room in between 30 and 45 minutes if possible.

Host:   I know that at UAMS, it’s a comprehensive stroke center. Can you speak to a moment about what it means to be in a comprehensive stroke center?

Dr. Radvany:  So there are several levels of stroke centers that have been designated by certifying bodies such as [inaudible]. The introductory level, so to speak, the primary stroke center are centers that can diagnose a stroke and then start giving a medication called tPA to try and dissolve the clot. About 30% of patients will have a clot that is too big to be dissolved by that medication. The next level of treatment is a thrombectomy capable stroke center is a center that has positions that are able to go up and pull the clot out of a blocked artery. A comprehensive stroke center is the highest level of certification where they can perform everything that a primary and a thrombectomy capable stroke center can perform, but they also treat the full spectrum of neurovascular disease. So not just stroke but also brain aneurysms, brain arterial venous malformations.

Host:   Obviously if you had to pick one of those, the more comprehensive the better.

Dr. Radvany:  Correct. If someone is truly having a stroke, their best chance of having a good outcome/good quality of life is to get to a hospital that can provide the highest level of care.

Host:   Thanks for the information doctor. That’s Dr. Martin Radvany, chief of interventional neuroradiology at UAMS. Thanks for checking out this episode of UAMS Health talk. For more information, visit uamshealth.com to get connected with Dr. Radvany or another provider. If you found this episode helpful, please share it on your social channels. Be sure to check the entire library of past episodes for topics of interest to you.