Diagnosing and Treating Stroke

If you're experiencing a stroke, you need to see a doctor right away. If a stroke is diagnosed quickly - right after symptoms start - doctors may be able to use medicines that can help you recover better.

The first thing the doctor needs to find out is what kind of stroke it is: ischemic or hemorrhagic. This is important, because the medicine given to treat a stroke caused by a blood clot could be deadly if used for a stroke caused by bleeding in the brain.

There are two types of stroke:

  • An ischemic (say "iss-KEE-mick") stroke happens when a blood clot blocks a blood vessel in the brain. The clot may form in the blood vessel or travel from somewhere else in the blood system. About 8 out of 10 strokes are ischemic strokes. They are the most common type of stroke in older adults.
  • A hemorrhagic (say "heh-muh-RAW-jick") stroke develops when an artery in the brain leaks or bursts. This causes bleeding inside the brain or near the surface of the brain. Hemorrhagic strokes are less common but more deadly than ischemic strokes.

How is a stroke diagnosed?

You need to see a doctor right away. Call 9-1-1 immediately for help. 

To find out what kind of stroke it is, the doctor will do a type of X-ray called a CT scan of the brain, which can show if there is bleeding. The doctor may order other tests to find the location of the clot or bleeding, check for the amount of brain damage, and check for other conditions that can cause symptoms similar to a stroke.

Stroke Treatments

Our stroke team uses the latest medical technology and techniques to diagnose stroke, along with minimally invasive treatments such as:

Clot-busting medicine

Special medicine (tissue plasminogen activator or tPA) can be used to treat ischemic stroke, but it can only be used within 4.5 hours of when symptoms begin. It’s delivered through an IV in your arm.

Clot removal (thrombectomy)

A neurologist or neurosurgeon who specializes in endovascular treatment can remove a blood clot using a catheter (small, flexible tube) to guide a clot-retrieving device. Your doctor performs the procedure through a tiny incision.

Reopening narrowed arteries (angioplasty or endarterectomy) 

A neurointerventionalist can restore blood flow through two different minimally invasive procedures. By compressing or removing plaque buildup against the walls of an artery or placing a stent (mesh tube) in the artery to improve blood flow, these procedures reduce the risk of stroke.

Embolizing procedures

An endovascular specialist (a neurologist who specializes in image-guided procedures) can use a catheter to:

  • Deliver medicine that clots the blood 
  • Close off a broken vessel
  • Place a rupture-prevention device (such as a coil) in a vessel to prevent stroke

Cerebral artery bypass surgery

A neurosurgeon can reconnect blood flow by connecting a blood vessel inside the brain to a blood vessel outside the brain, essentially bypassing a blocked or damaged artery. This procedure helps prevent strokes from occurring. 

If your condition can’t be treated with a minimally invasive procedure, our expert neurosurgeons can perform even the most complex neurosurgery to restore blood flow. You’ll receive the most advanced care in our neurointensive care unit. The unit is specially designed for people with brain and spine conditions, and it’s the only one of its kind in mid-Missouri.

The comprehensive stroke center difference

In order to receive a Comprehensive Stroke Center designation, a stroke center must meet many requirements — for timing, staffing, processes and more. Here’s a breakdown of some of the differences you’ll find at a comprehensive stroke center versus a primary stroke center.

    Primary Comprehensive
clock icon Patients have brain imaging completed within 35 minutes of an order and imaging is available 24/7    
ribbon icon Stroke processes and outcomes are measured and reviewed to improve quality of care    
doctor icon Stroke center medical director is a board-certified neurologist who has completed a stroke fellowship    
24/7 icon Stroke neurologists, critical care physicians, neurosurgeons, neuro-radiologists and imaging staff are available 24/7 and there is a process in place to treat simultaneous emergent needs of two or more complex stroke patients    
hospital bed icon Has dedicated neuro-intensive care unit beds for complex stroke patients with specific neuro-critical care physician and nursing staff on site 24/7    
head with gears icon Patient is assessed for cognitive decline, depression and other social issues prior to discharge using evidence-based screening tools    
patient chart icon Assessment of caretakers' skills, capacity and resources to supply post-hospital care    
nurse icon Coordinates post-hospital care for patients    
brain and microscope icon Active participation in stroke research    
certificate icon Specific training and education for all nurses providing care in the emergency department, acute stroke unit, intensive care unit and neuro-endovascular lab