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Bringing an ER to Stroke Patients

Mobile units can get help to people when every minute counts

Mobile stroke unit

Courtesy of Frazer Bilt

MICHAEL SMITH, now 73, was spreading peanut butter on an English muffin one morning last January when, he says, “suddenly I couldn’t let go of the knife and my mouth sort of hung open.” Recognizing that he was having a stroke, his wife, Mary, called 911. As emergency medical technicians rolled Smith out of his Phoenix condo on a stretcher, the Barrow Neurological Institute’s mobile stroke unit rolled into the condo’s parking lot.

Smith, a retired architect, describes being wheeled into “a miniature emergency room” right there, outside his building. “The stroke team checked my vitals, did a CT scan of my brain, conferred with a neurologist and administered a clot-busting drug, all in less than an hour. Their fast action is the reason I’ve recovered so well.”             

During a stroke, treatment access time is essential: 1.9 million neurons and 7.5 miles of nerve fibers in the brain die during every minute of a stroke. “Getting treatment within an hour can be the difference between resuming your life at 90 percent or better capacity, and being bedridden and dependent on other people for the rest of your life,” explains neurologist Michael Waters, director of Barrow’s Stroke Program. But, he adds, it’s critical to diagnose the cause as fast as possible, because administering the wrong treatment could be fatal.

That’s why hospitals are taking the ER to the stroke victim. Ten U.S. cities have mobile stroke units. But the price tag for these big ambulances is $1 million, plus an estimated $1 million in annual operating costs, sparking a national debate about whether the results are worth the cost. A nationwide study is expected to provide an answer in a few years. “Compare it with the long-term cost of a devastating stroke, in terms of treatment, long-term care, rehab and lost wages in someone’s peak years of productivity in their 30s, 40s, 50s or 60s, and I think mobile stroke units will prove their worth,” Waters says. Smith agrees: “I’m a big fan,” he notes. “You’d have to work pretty hard to convince me they’re not worth the money.”


On the Horizon: Stroke Treatment

“With ischemic stroke, new imaging software allows us to more precisely define the area of stroke damage around a blocked blood vessel in the brain and the area of salvageable brain tissue. This lets us effectively treat more patients without knowing exactly when their symptoms arose — even to treat patients who have a stroke while sleeping.”

— MICHAEL WATERS, neurologist and director of the Barrow Neurological Institute Stroke Program in Phoenix


Aggressive Blood Pressure Treatment May Cut Dementia Risk

Keep this number in mind: 120. It might be the crucial figure that keeps you from developing dementia, according to a study presented this past summer. Study participants who kept their systolic blood pressure (the top number) at or below 120 were nearly 20 percent less likely to develop dementia than those whose levels reached 140. Systolic blood pressure is the pressure generated during a heartbeat and is the most common form of high blood pressure in people older than 65. The American Heart Association recommends treatment for anyone whose systolic pressure is greater than 130, though this research suggests a more aggressive approach could take a strain off your brain.

Marijuana-Based Drug Reduces Seizures

An estimated 1 million Americans 55 and older have active epilepsy, meaning they’re at risk for a seizure at any time. Now the FDA has approved the nation’s first drug derived from the marijuana compound cannabidiol (CBD) for two rare and severe forms of epilepsy — Lennox-Gastaut syndrome and Dravet syndrome — that begin in early childhood. In one recent study, CBD reduced seizures in Lennox-Gastaut patients who were ages 2 to 55.

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