Ohio State’s Comprehensive Neurovascular Stroke Center is skilled at treating the most complex strokes and cerebrovascular diseases.

A stroke is a medical emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes," or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted.

Symptoms of stroke are:

  • Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
  • Sudden confusion, trouble speaking or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

If you have any of these symptoms, you must get to a hospital quickly to begin treatment. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot or by stopping the bleeding. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Drug therapy with blood thinners is the most common treatment for stroke.

Source: NIH: National Institute of Neurological Disorders and Stroke

Why choose Ohio State for treatment of stroke?

Comprehensive Stroke Center Certification: At The Ohio State University Wexner Medical Center’s Comprehensive Neurovascular Stroke Center, we are skilled at treating the most complex strokes and cerebrovascular disease. We are one of only three Ohio hospitals that have achieved the elite status of Comprehensive Stroke Center from The Joint Commission and the American Heart Association/American Stroke Association and one of the first 26 stroke centers across the United States to have received this recognition.

Continuum of Care: From the moment you enter our emergency department, you will be cared for by people specially trained in stroke care. Our stroke neurologists oversee your care from diagnosis through treatment in a dedicated stroke unit or in our Neuro Intensive Care Unit (Neuro ICU). As your treatment progresses, we provide follow-up care with stroke rehabilitation and at our outpatient stroke clinic.

Other members of our multidisciplinary stroke team include:

  • Board-certified vascular neurologists and vascular neurosurgeons
  • Certified stroke rehab physicians
  • Nurse practitioners who specialize in stroke care
  • Neuro ICU nurses
  • Stroke care nurses
  • Stroke rehab therapists

Neuro Intensive Care: Our five fellowship-trained, board-certified stroke neurologists are certified in critical care, meaning we provide unparalleled stroke management for the most severe complications of stroke.

Stroke Rehabilitation: We offer specialized services such as an Assistive Technology Center, Community Re-entry Program and Rehabilitation Driving Program to allow you to resume your life. We are unique in Ohio for developing gaming as a strategy for stroke rehab and recovery from paralysis. We continue to investigate ways for video games, machines and apps to help the brain adapt and recover.

Telestroke Network: Ohio State is the hub for the Telestroke Network, which delivers Ohio State’s critical stroke expertise into 27 hospitals in rural areas of Ohio. If you were taken to one of those emergency departments with stroke symptoms, experts would be mobilized both there and at Ohio State through a “stroke alert.” Through video technology that directly links our stroke specialist to the community hospital, we interview you, view your test results and vital signs and prescribe intravenous clot-buster medications to be given to you within minutes. Then our doctors work together with your hospital to determine what is the next best step for your treatment. Ohio State’s stroke team physicians are available around the clock for this service.

Physicians Trained for Both Surgery and Radiology: We have physicians trained in both radiology and neurosurgery who work in a uniquely designed operating room equipped with X-ray capabilities. By viewing X-rays and providing surgical care in the same room, our physicians save time in moving you from doctor to doctor or room to room.

Research: Ohio State is the only central Ohio hospital participating in the National Institutes of Health (NIH) Neurological Emergencies Treatment Trials (NETT) network, which is developing ways to improve emergency care for severe injuries and illnesses of the brain, spinal cord and nervous system. Ohio State also is part of the NIH StrokeNet, an elite network of 25 regional stroke centers that develop and conduct high-quality, multisite clinical trials focused on stroke prevention, treatment and recovery.

Diagnosis

Diagnosing Stroke

Ohio State has a stroke team in-house around-the-clock to assess people for stroke the moment they arrive in the emergency department. A stroke alert is called by paramedics while the patient is being transported to the hospital, so we are ready to evaluate you and get an immediate computed tomography (CT) scan upon your arrival. This CT scan helps us see bleeding in the brain or damage to the brain cells from a stroke.

Other diagnostic tests we use to verify a stroke include:

  • CT angiography, which combines CT and a special dye to examine blood vessels and detect abnormalities
  • CT perfusion scan, which uses dye and a series of CT images to determine blood flow to a region of the brain
  • Magnetic resonance imaging (MRI), which can detect changes in brain tissue and damage to brain cells from a stroke
  • MR perfusion scan, which can be performed with or without dye to provide a blood  flow map of the brain
  • CT arteriogram (CTA) and magnetic resonance arteriogram (MRA), which show the large blood vessels in the brain. These tests may give us more information about the site of a blood clot and the flow of blood through your brain
  • Cerebral angiography, a test that uses dye and special X-rays to show the insides of blood vessels in the neck and head

Treatment and Rehabilitation

Treating Stroke

Ohio State is the only medical center in central Ohio to provide immediate bedside care around the clock by a stroke neurologist for any patient suspected of having a stroke. This attention speeds the treatment process and provides the best possible opportunity to save brain tissue. And our entire stroke team, including stroke neurologists and neurosurgeons, imaging specialists and technicians, is available within moments.

Neuro Intensive Care

Because a stroke not only affects the brain but other organs such as the heart and lungs, patients often require intensive care to maintain essential body functions.

Our stroke neurologists on our Neuro Intensive Care Unit have critical care training that equips us to:

  • Manage medical complications such as heart attack and respiratory failure
  • Control blood pressure and diabetes
  • Treat pneumonia and other infections common in people who have strokes
  • Manage brain swelling and elevated pressure inside the skull for hemorrhagic strokes

Even the nurses who staff the Neuro ICU have specialized training in caring for people who have had strokes.

Ischemic Stroke

With an ischemic stroke, a clot stops blood flow to a portion of the brain. Ohio State stroke specialists give tPA, a clot-busting drug, to patients suffering an ischemic stroke. The earlier in the stroke’s onset the drug is given, the more quickly blood flow can be restored.

If the window of time during which tPA is effective (up to four-and-a-half hours from symptom onset) is missed, our neurosurgeons can perform a:

  • Thrombectomy, in which we insert a catheter into your groin and thread it to the area of the clot. The catheter is equipped with either a suction device or a mechanical device to remove the blood clot from your artery.
  • Intra-arterial thrombolysis, in which we insert a catheter and thread it to the tiny arteries in your brain. We inject medicine through the catheter to dissolve the blood clot.

To prevent an ischemic stroke in someone who has carotid artery disease (plaque buildup in the arteries of the neck that supply the brain with blood), our surgeons also perform carotid endarterectomy to remove plaque that might allow a clot to form. Angioplasty also helps open blocked carotid arteries by inflating a tiny balloon on the tip of the catheter to compress the plaque buildup against the carotid artery walls.

Hemorrhagic Stroke

With hemorrhagic stroke, our goal is to stop the bleeding into the brain, usually caused by a weakened blood vessel.

Our Neuro Intensive Care team is dual trained in stroke neurology and critical care, making us highly skilled in managing subtle changes in blood pressure and swelling in the brain with a variety of medications.

If medications fail to stop the bleeding, our stroke neurosurgeons dually trained in neurosurgery and radiology will take X-rays and perform surgery in a hybrid operating room, saving critical time.

Other procedures performed in our hybrid operating room include:

  • Aneurysm Clipping: Our neurosurgeons can clip the aneurysm (balloon-like bulge in an artery) to block it off from the blood vessels in the brain to prevent bursting or further leaking.
  • Coil Embolization: Our neurosurgeons insert a tube called a catheter into an artery in the groin. The surgeon threads the tube to the site of the aneurysm and pushes a tiny coil through the tube into the aneurysm to cause a clot to form, block blood flow through the aneurysm and prevent it from bursting again.
  • Arteriovenous Malformation Repair (AVM): Our surgeons open the skull to stop bleeding and to drain off extra spinal fluid that could cause the brain to swell.

Stroke Clinic

At Ohio State’s Stroke Clinic, our stroke neurologists provide ongoing outpatient care for people from across Ohio and nearby states. If you are at high risk for a first or second stroke, we evaluate and manage your risk factors, such as diabetes, high blood pressure and hormone imbalances.

Our clinic also helps you continue to progress after a stroke with rehabilitation. Our therapists can prevent complications such as a spastic arm or contracted hand, and can help you overcome depression and manage stress brought on by changes stroke has brought to your life.

Stroke Rehabilitation

We are leaders in developing and administering the most current therapeutic options, including human/machine interfaces that drive the brain’s recovery and restructuring. We offer you a range of specialized support services unparalleled in central Ohio to help you maximize your ability to function safely and independently at home and to participate in your community.

Through the Stroke Rehabilitation Program, your rehabilitation plan at Ohio State may include:

  • Optimizing brain plasticity (using sensory input and cognitive therapies to stimulate the brain to change, adapt and reorganize itself)
  • Exercising to help improve strength, swallowing, communication and thinking
  • Enhancing skills needed to perform daily activities
  • Developing strategies to compensate for functional deficits
  • Adapting leisure activities for enhanced quality of life

Telestroke Network

Our Telestroke Network

Ohio State serves as the hub of the Telestroke Network and provides other hospitals with rapid access to board-certified vascular neurologists who can provide real-time consultation to physicians at the proximity hospitals using video equipment, CT scans, web-based software and proven stroke protocols. This additional evaluation and support can be lifesaving when time is critical. Should the patient require an advanced level of care, a transfer to Ohio State’s Neurovascular Stroke Center is arranged.

The goals of the Telestroke Network are to:

  • Increase access to advanced stroke care in underserved regions of Ohio
  • Improve EMS response and recognition of stroke signs and symptoms
  • Enhance quality and efficiency within the health care system

Ohio State’s stroke team, which includes board-certified vascular neurologists, board-certified neurocritical care physicians and vascular neurosurgeons, is available any time, day or night.

Patient Stories

Getting her life back after stroke

Getting her life back after stroke


Olivia's Story

Olivia never thought she would experience a stroke at 20 years old. What started as a really bad headache, Olivia and her care team share the story of the day she was rushed the Ohio State's Wexner Medical Center.

When stroke strikes, others’ observations matter

When stroke strikes, others’ observations matter

Michael's Story

“Out of the blue, everything starting spinning, including the words on the computer screen,” says Michael. “I was not terribly worried and thought it would go away if I changed positions, which can help if you have an inner ear infection, for example. I had a difficult time dialing the phone because of the unrelenting spinning sensation, but I managed to call my wife to tell her I’d be late because I didn’t feel well and was going to lie on the floor before driving home. It didn’t occur to me that what was happening was anything significant.”

The call struck his wife as odd, and she called her husband’s work, The Ohio State University Wexner Medical Center’s University Hospital East, to have someone check on him. Two other emergency medicine physicians went to Michael’s office and assisted him in making the short trip to the Emergency Department. By that time, he was vomiting uncontrollably. Still, he told them he was OK and didn’t need medical help.

“Clearly, I didn’t understand what was happening,” he says. “I was insistent that I could take some medicine and be back to work in the morning.”​

Objective Thinking Helps the Patient

Michael’s colleagues ordered imaging tests that showed he’d had a stroke in the back right portion of his brain. He was transferred to University Hospital for specialty neurology and neurosurgery care, should surgery become necessary. He spent seven days in the hospital.

“The vomiting persisted for four or five days, and I had swelling in my brain in the area of the stroke,” says Michael. “My physicians were concerned, if the swelling continued, they might need to intervene. But that wasn’t necessary.”

Michael had many tests to explore the cause of the stroke. Commonly in a stroke, a blood clot from somewhere in the body travels to the brain and blocks the blood supply. Getting immediate medical attention and clot-busting medication to dissolve the clot and restore the blood supply to the brain helps minimize damage from the stroke. In Michael’s case, the inside layer of an artery peeled away from the outer layers and fell into the blood vessel, blocking blood supply from that vessel. Clot-busting medication would not have made a difference.

“The physicians couldn’t determine what caused my stroke, and my other blood vessels and heart received a clean bill of health,” says Michael. “I didn’t have to adjust my lifestyle and am not at risk for a recurrence. I spent four days in rehabilitation, working with physical therapists to regain my balance, which came back relatively quickly.”

Recovery Facilitated by Good Physical Condition

Eight weeks after the stroke, Michael not only returned to work in the Emergency Department, he ran the Nationwide Children’s Hospital Columbus Marathon. “I was signed up for the marathon before the stroke and was determined to make it,” he says.

Michael says his recovery was aided by his good overall physical condition. “I am active and eat pretty well. I think I recovered quickly because I was in good shape,” he says. “Even healthy people can have something go wrong, even if it’s just a broken bone. Your recovery chances are optimized if you are in better condition already.”

Act If Something’s Not Right

Michael emphasizes that stroke symptoms can take many forms and depend on the area of the brain affected. His symptoms were not classic, but his colleagues recognized that something was not normal about his condition and rushed him to the Emergency Department.

“I work in emergency medicine, and I didn’t recognize what was happening to me,” he says. “My experience highlights the importance of others friends, family and co-workers noticing when someone is having a medical problem and taking prompt action. Do what you think is appropriate, even if the individual in question insists it’s not necessary.”

Research

Research

Ohio State’s stroke program is improving health care by developing the next breakthroughs in stroke prevention, diagnosis and care.

We are one of only 10 stroke centers in the country selected by the National Institutes of Health to be part of both its Neurological Emergencies Treatment Trials (NETT) network to improve emergency care for severe injuries and illnesses of the brain, spinal cord and nervous system, and its StrokeNet, an elite network of 25 regional stroke centers conducting clinical trials on stroke prevention, treatment and recovery.

In addition, we are a member of the NIH’s NeuroNEXT: Network for Excellence in Neuroscience Clinical Trials. This collaboration results in more promising treatments, more rapidly, to provide patients like you more hope for stroke prevention and treatment.


Enroll in a clinical trial


Our current studies include:

Video game development for stroke rehab

Our researchers have developed a video game to help the brain regain function, compensate for lost function and promote movement. Subject matter is geared toward a population age 50 and older. The game can be played at home and operates on Xbox Kinect with a control device. Its effectiveness has been tested and is comparable to computer simulations in a daily rehab program, but the cost will be much lower. Investigators are working on strategies to make the game widely available for home use.

Ultrasound therapy for stroke

We are investigating the effect of transmitting ultrasound signals to the clot that is causing a stroke to aid the work of the medication tPA in breaking up the blood clot.

Glucose control in acute stroke

Our investigators are studying ways to protect the brain during an acute stroke by looking into the effect of strict glucose control on the brain.

Preventive medication for pre-diabetes

We are part of an NIH study of a drug that may decrease the risk of further strokes in people with pre-diabetes.

Device to close a hole in the heart

Industry-sponsored comparative study is following progress of people who have had an umbrella-like implant placed in a hole in their heart (patent foramen ovale or PFO). Medical experts believe that closing the hole with the device will reduce the number of clots that break loose and move through the hole to the brain. The study focuses on continued follow-up of people who have the device and did not have a clearly documented clot, as compared to those who have a hole in the heart but don’t have the device.

Vitamin E

We are investigating a special type of vitamin E that may be effective for blood-thinning and cholesterol-lowering, which could reduce the severity and damage caused by a stroke.

Optimal blood pressure control in patients with hemorrhagic stroke

This study, sponsored by the National Institutes of Health, is trying to pinpoint the best blood pressure range to facilitate complete resolution of stroke symptoms or improvement in stroke deficits over time, such as movement and speech.

More +

Novel medications for prevention of second stroke

In cooperation with a pharmaceutical company, we are conducting a five-year study of the effectiveness of aspirin versus a new medication in preventing secondary strokes.

Alternative thrombolytic agents (clot busters)

Ohio State is conducting our own randomized trial to determine whether new medications are superior to the standard treatment of tPA in breaking up blood clots that cause stroke.

Stroke risk following ruptured aneurysm

We are studying patients with ruptured aneurysms to better predict which people are at risk for narrowing and irritation of the blood vessels (vasospasm) after aneurysm that can lead to a stroke. Researchers are analyzing blood and spinal fluid to look for clues that would predict higher stroke risk. If a pattern can be found, the patients at higher risk could continue with medical management and delay rehab in the hope of preventing stroke.

MISTIE III for a deep clot in the brain

We are one of 100 centers in this international study investigating the exact location of a blood clot through a coordinate process called stereotaxis and drilling a small hole in the skull to access and remove the clot. Early results from MISTIE II suggest that the technique reduces the rate of death, allows a patient to receive rehab more quickly and improves the patient’s neurologic functioning and quality of life in the year following a stroke.

Are you at risk for stroke?

Are you at risk for stroke?

Up to 80 percent of all strokes can be prevented. Certain risk factors, like your age or gender, cannot be changed, but you do have control over many of the risk factors for stroke.

Lower your risk and follow these tips

Know your numbers

Uncontrolled high blood pressure is the leading cause of stroke.

Have your cholesterol level checked and know your cholesterol levels, including your HDL cholesterol (good), LDL cholesterol (bad) and triglycerides (bad).

Don’t smoke

Smoking is the single most preventable cause of death in the United States. Smoking doubles your risk of stroke, so stop smoking today!

Exercise

Getting 30 minutes of vigorous activity every day helps control your stroke risk.

Eat fruits and vegetables

A diet containing five or more servings of fruits and vegetables per day can help reduce your risk of stroke.

Our Doctors

Additional Information

When you are visiting our Stroke Clinic for the first time, please bring any medical records from previous hospitalizations, clinic visits or specialist consults. We also request that you bring a CD of imaging studies, including X-rays, MRIs or CTs of the brain.

Preparing for your visit

Support Groups

Brain Aneurysm Awareness and Support Group

The Ohio Brain Aneurysm Awareness and Support Group provides an opportunity for patients and their caregivers to discuss their feelings, learn coping skills and support others. Meetings are held every second Thursday of January, March, May, July, September and November from 6 to 7:30 p.m. Light refreshments are served.

Location: Dodd Hall Rehabilitation Services, 480 Medical Center Drive, Room 2136

Contact: 614-293-0689

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