Comprehensive stroke program formed

People generally know that stroke is an emergency, but few can recognize it quickly, and that defeats the purpose, said Steven Levine, MD, professor of neurology. As director of the Wayne State University/Detroit Medical Center Comprehensive Stroke Center, Dr. Levine is striving to educate patients and health care workers about the emergency status that needs to be associated with stroke recognition and treatment.

The team at the Comprehensive Stroke Center is developing novel approaches to the prevention and treatment of stroke.

The education objectives and strategies are different for each audience. For lay audiences, the staff at the Comprehensive Stroke Center are establishing annual stroke risk assessment programs to help people recognize their risk factors and receive treatment for related conditions. For medical audiences, the center is beginning to utilize telemedicine to provide stroke expertise to health care professionals in multiple locations.

The concept of yearly stroke assessment screening is a novel approach to stroke prevention. “Just as women get an annual reminder for their mammogram, we will remind people to check their risk for stroke. This includes screening and treatment for diabetes, high cholesterol, heart disease, smoking and high blood pressure,” Dr. Levine said. Although stroke researchers can predict who is most likely to suffer from stroke, there is no comprehensive or coordinated mechanism for informing patients that they are at-risk.

“All these risk factors are treatable, so stroke can generally be prevented. Currently, however, most smokers don’t know they are at  increased risk for stroke and people with diabetes don’t automatically receive advisement and information, even though they are also a high-risk group,” said Dr. Levine. The team at the stroke center will help coordinate resources within the university and medical center, so that primary problems will not result in secondary stroke.

Another major push in the center’s educational mission for the stroke program is to provide stroke consultation and expertise via telemedicine. “The technology is available to put an acute stroke expert in every emergency room, even though the expert is located in one single office,” he said. “Stroke is a particularly urgent emergency condition because there is only a three-hour window of opportunity to use proven medications for treatment. You can’t wait one week to see a specialist for the acute problem. You may literally have only moments to make a diagnosis and treatment determination. One week is too long for a brain that is losing its blood supply.”

A pilot program beginning this year will connect all DMC hospitals to a central location through video monitors. In this way, a stroke specialist sitting at one hospital can see and interact with the patient, the emergency physician, family, and nurses at another hospital in moments, when effective medication still has time to work in a stroke victim.

The WSU/DMC Comprehensive Stroke Center will build on the current research program with faculty experts including Drs. William Coplin, Mark Gorman and Bradley Jacobs. The research programs focus on finding new drugs and new dosages of drugs to be effective against stroke for longer periods of time. They will also investigate genetic factors related to stroke and stroke risk, stroke epidemiology in the sate of Michigan and stroke related to sickle cell disease, eclampsia and disorders of clotting.