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Evanston Hospital Receives Certification for Primary Stroke Center

ENH Hospital becomes the only Primary Center for Stroke Treatment and Research on the North Shore

12/15/2006 - Evanston Northwestern Healthcare’s Evanston Hospital has been approved as the only Certified Stroke Center on the North Shore by The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO).

Every 45 seconds, someone in the United States has a stroke. It is the third leading cause of death and the number one cause of disability in the United States. A stroke is also known as a “brain attack,” and can damage the brain as a heart attack can damage the heart. Oftentimes speech, movement and memory are affected by strokes because the cells die in the part of the brain that controls these abilities. More than 2/3 of stroke survivors will be left with some kind of disability.

Dr. Daniel Homer, Director of the Evanston Hospital Stroke Center, says the only effective method to reverse a stroke is an intravenous tissue plasminogen activator (tPA), which must be administered within three hours of symptom onset.

“Very few stroke victims are treated today, because all stroke treatments depend on very rapid response time by the public, 911 responders, the emergency department staff and by stroke specialists,” said Dr. Daniel Homer. “The concepts behind Primary Stroke Centers include a heightened state of readiness for stroke patients, making sure hospital-wide mechanisms are in place to rapidly identify and intervene in acute stroke and a multi-disciplinary team who can deliver rapid and sophisticated care.”

The Primary Stroke Center will include an Acute Stroke Team for rapid diagnosis and treatment. They will be staffed 24 hours a day, seven days a week, led by Dr. Homer, Dr. Dennis Groothuis and Dr. Richard Munson, who will head a dedicated stroke treatment unit. Clinical nurse specialist, Deborah Lynch and neurovascular surgeon, Dr. Issam Awad, will also provide medical treatment for stroke victims. A stroke registry nurse and a nurse educator will be available to families for support and education.

Dr. Munson believes having a dedicated stroke unit at Evanston Hospital will help ensure that patients benefit from advances in knowledge of stroke treatment. “Volumes of data are published every year on the management of stroke patients,” he said. “The stroke unit will enable us to filter, implement and evaluate this information in a rational and consistent manner, with the aim of improving the quality of life for our patients.”

Teaming with neurovascular surgeons can be crucial when a stroke patient is brought into Evanston Hospital. Dr. Awad says, “Neurovascular surgeons intervene in certain types of strokes to relieve pressure from the brain, drain a bleed or correct a blood vessel anomaly, which may cause another stroke. In these situations, the availability of a neurosurgeon who is specialized in cerebrovascular disease can be lifesaving.”

There are only 200 Primary Stroke Centers nationwide. Evanston Hospital was required to meet stringent JCAHO criteria based on recommendations by the Brain Attack Coalition. Some of the criteria include: an Acute Stroke Response Team – available 24/7/365 – that can administer tPA promptly and appropriately; integration of EMS providers into the transport, care and early notification to the Emergency Department of in-coming stroke patients; an Emergency Department staff that is trained to triage stroke patients similarly to trauma patients and to immediately activate the Acute Stroke Response Team; a Stroke Unit with a specially trained nursing staff and high-acuity clinical and technical monitoring of the stroke patient.

There are two types of strokes. The most common is an ischemic stroke. It is usually caused when a blood vessel carrying blood to the brain is blocked by a blood clot. The clot is often a result of a plaque build up on the artery walls. The plaque interferes in the normal blood flow and causes the clotting.

The second is hemorrhagic. This kind is caused by a blood vessel that breaks open and causes bleeding in the brain. It can occur when blood vessels in the brain become weak and burst. Hemorrhagic strokes are more fatal than ischemic.

80 percent of strokes are preventable. To help prevent a stroke, follow a low-fat diet, quit smoking, treat high blood pressure, high cholesterol, diabetes and heart disease, exercise regularly, have your cholesterol checked and lose weight if you are overweight.

Some people do not realize they have suffered a stroke. The symptoms can vary, depending on the part of the brain that has been affected. There are several symptoms of stroke, including:

  • Weakness, or paralysis of an arm, leg, side or any part of the body
  • Tingling, numbness or decreased sensation
  • Slurred speech or inability to speak
  • Vision changes or eyelid drooping
  • Difficulty swallowing
  • Loss of balance or coordination
  • Loss of consciousness, lethargy or drowsiness

African Americans are at a higher risk and have a higher mortality rate, often because of high blood pressure, diabetes, smoking and sickle cell anemia.

Philanthropy has played an integral role in establishing several of the key components necessary for the formation and certification of a Primary Stroke Center at Evanston Hospital.  The Staubitz Family Trust created ENH’s Stroke Registry five years ago, enabling the collection of clinical data to track and improve the quality of stroke care at Evanston, Glenbrook and Highland Park Hospitals.

The Primary Stroke Center will grow to include Glenbrook and Highland Park Hospitals.