May is National Stroke Awareness Month, and we spoke with RP’s National Subspecialty Lead (NSL) for Neuroradiology, Dr. Vivek Bansal.
Dr. Bansal discussed the importance of stroke awareness by identifying symptoms, risk factors and treatments.
What is a stroke?
There are two main types of strokes:
- 90% of strokes are caused by a clot blocking blood flow to part of the brain, which is similar to a heart attack.
- 10% of strokes are caused by bleeding within the brain.
In the United States, stroke is currently the fifth leading causing of death and the leading cause of long-term disability. In fact, approximately every 40 seconds, someone in the United States suffers a stroke. The mantra in stroke care is “time is brain,” meaning the quicker you can identify someone is having a stroke, the better chance for a more favorable outcome for the stroke patient due to earlier therapy.
What are the most common symptoms of stroke?
One easy way to remember common stroke symptoms is with the mnemonic “BE FAST,” which stands for:
- Balance: Sudden loss of balance or dizziness
- Eyes: Sudden loss of vision in one or both eyes
- Face: Facial drooping or numbness on one side; lopsided smile
- Arm/Leg: Weakness or numbness in one arm or leg
- Speech: Slurred or incoherent speech
- Terrible/thunderclap headache: Sudden onset of severe headache
If someone you know is having any of these symptoms, it is important to call 911 right away.
What often leads patients to suffer a stroke? What is the best prevention for stroke?
Some risk factors for stroke are beyond our control such as age, gender, race and family history. However, there are many risk factors that we can control such as high blood pressure, high cholesterol, smoking and obesity. Up to 80% of strokes are preventable with lifestyle changes such as eating a healthy diet, quitting smoking and participating in regular physical activity. It is also important to continue routine visits to your doctor.
What are current treatments for stroke?
For many years, the only treatment option available to someone having a stroke was intravenous injection of tissue plasminogen activator (tPA), also known as “clot busters.” This medicine could only be administered within 3 hours from the onset of symptoms for most patients and up to 4.5 hours for some patients.
In the last five years, there has been rapid advancement in stroke guidelines, and now more patients are eligible for tPA up to 4.5 hours from stroke onset. Additionally, there have been significant improvements in mechanical thrombectomy and advanced imaging for stroke, extending the treatment window to 24 hours in appropriate patients and increasing the number of strokes that can be successfully treated. Despite the extended window, it is still critical to get treatment as fast as possible to preserve the most brain function.
We’ve seen many exams and screenings canceled at the height of the COVID-19 pandemic. If a patient is at risk of stroke, what should they do first?
We now know that COVID-19 has a propensity to increase blood clots throughout the body including in the brain. Despite this, we saw a dramatically decreased volume of stroke admissions during the height of the pandemic. While this is understandable as many people were scared to leave their homes and even more scared to enter a hospital for non-COVID issues, due to the severity of stroke, it is important to continue with lifestyle modifications and seek urgent medical care if you have symptoms of a stroke.
What drew you to neuroradiology?
I was always fascinated by the brain and previously worked as a research engineer developing tools for functional neuroimaging. There has been a tremendous amount of scientific progress in neuroscience, including advanced imaging, which is helping us understand more about how the brain works. Right now is a particularly exciting time to be involved in neuroscience because we are starting to see scientific discoveries translated to improved patient care.
What are you focused on in your role as NSL for Neuroradiology at RP?
I want to utilize the talent we have across Radiology Partners to implement best practices for neuroimaging. For stroke specifically, we have an opportunity to directly impact the lives of many patients and give them the best chance for a favorable outcome after suffering a stroke. Utilizing our national resources will ensure that we are delivering high-quality subspecialty level care at all sites.
Dr. Vivek Bansal is the National Subspecialty Lead for Neuroradiology at Radiology Partners, the largest physician-led and physician-owned radiology practice in the U.S. For the latest news from RP, follow along on our website and on Twitter, LinkedIn and Instagram.