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High-Tech Way to Diagnose Stroke

By Joanne Pallotta
Beth Israel Deaconess Medical Center correspondent

Every minute counts in a suspected case of stroke. Now, participating community hospitals in the Beth Israel Deaconess Medical Center (BIDMC) network have 24/7, immediate lifesaving access to stroke specialists at BIDMC.

With the TeleNet:Stroke service, emergency department physicians and local neurologists can use two-way video conferencing and image-sharing technology to connect with a specialist to assess and treat patients presenting signs of stroke.

“The biggest benefit is that TeleNet:Stroke allows the patient to be evaluated by a person who specializes in neurologic diseases, in real time,” says Gary Cole, MD, a physician in the Emergency Department at Beth Israel Deaconess Hospital-Plymouth.

What is TeleNet:Stroke Service?

TeleNet:Stroke service is a program that allows community hospitals to get an immediate diagnosis and treatment to a patient suspected of stroke. By collaborating with neurologic specialists, hospitals in the network can improve care while keeping a patient close to home, using this high-tech system.

Dr. Cole points out most community hospitals do not have a neurologist on-site 24 hours a day, 7 days a week. But with TeleNet:Stroke, Dr. Cole says a specialist can actually see, examine and interact with the patient in real time, enabling the team to make an accurate decision to administer medication and develop a treatment plan.

“We can quickly, accurately, and efficiently evaluate stroke patients to determine if they are candidates for thrombolytic therapy,” says Dr. Cole.

How the Program Works

After a patient is evaluated by the emergency department physicians and a Computerized Tomography (CT) scan is performed, a TeleNet:Stroke consultation with a neurologist at BIDMC is requested. Through the use of video conferencing and in collaboration with the emergency department team, the specialist will:

  • Review the patient’s history, tests, and brain imaging
  • Conduct additional tests
  • Interview and interact with the patient and/or family to make an assessment
  • Confer with the team about diagnosis

Additional tests may be conducted, tPa (tissue plasminogen activator) administered, and admission to the hospital discussed. For cases in need of advanced intervention not available at a local hospital, transfer to BIDMC in Boston is considered.

What is Stroke?

A stroke occurs when a blood clot blocks an artery or a blood vessel breaks, disrupting blood flow to an area of the brain. When either of these happen, brain cells begin to die and damage occurs.

When brain cells die during a stroke, abilities controlled by that area of the brain are lost. How a stroke patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged.

According to the National Stroke Association, 87 percent of all strokes are ischemic. Ischemic stroke occurs when a clot obstructs an artery. Hemorrhagic stroke happens when a blood vessel in the brain breaks, leaking blood into the brain.

Signs of Stroke

According to the Massachusetts Department of Health and Human Services, only one in four people recognize the signs of stroke.

“Time is critical,” emphasizes Dr. Cole. “There is a window where the therapy is shown to be a real benefit to the patient.”

The sooner action is taken, the more likely the effects of stroke can be minimized. It’s time for immediate medical attention if a person is unable to speak, has difficulty swallowing, experiences a change in his or her mental status, has weakness on one side of the body more so than the other, or experiences paralysis on one side of the body.

The Stroke Heroes ACT FAST campaign teaches the signs of stroke, emphasizing the need for immediate action. Check for the signs of stroke by acting F-A-S-T:

  • Face – Does the face look uneven?
  • Arm – Check to see if one arm is weak or drifts down.
  • Speech – Listen for strange or slurred speech. Ask the person to repeat a simple phrase.
  • Time – If any of these signs are observed, call 9-1-1 right away!

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor. 

October 2014

Contact Information

Division of Stroke and Cerebrovascular Diseases
Department of Neurology
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215

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Department of Emergency Medicine
Beth Israel Deaconess Medical Center
West Campus
190 Pilgrim Road
Boston, MA 02215

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