continued Physicians in Rochester and Auburn will employ a technology called Image Transfer. This web-based system allows physicians to remotely review computed tomography (CT) images and MRI of the patient’s brain to determine the most appropriate course of treatment for the patient.
The primary goal of this initiative is to overcome the geographic disadvantage in treating patients with acute ischemic stroke — a type of stroke caused when an artery in the brain becomes obstructed, cuts off the flow of blood, and, if not treated quickly, causes brain cells to die, often resulting in permanent neurological damage.
One of the key decisions in the care of individuals with ischemic stroke is whether or not to give patients a clot busting drug called tissue plasminogen activator (tPA). In order to be effective, tPA must be administered within three hours of the onset of the symptoms of stroke. This period of time is called the tPA “window” and once it has past, physicians are reluctant to administer the drug because it may cause dangerous bleeding in the brain.
In the absence of trained stroke specialists, it falls upon physicians in the emergency department to determine the course of treatment. Not all strokes are the same and the decision whether or not give the patient tPA is based on a complicated number of factors, which can contribute to a reluctance to use the drug without the consultation of a neurologist or a neurosurgeon. Consequently, the drug is only administered in a small fraction of strokes; of the more than 700,000 cases every year nationally, only an estimated two to four percent receive tPA.
For patients who are ineligible for tPA, recent advances in intra-arterial intervention — a procedure in which surgeons physically remove the clot from the blood vessel — may be another option. Patients who require advanced procedures not available at Auburn can be transferred to Rochester.