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.

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. At Ohio State our Carotid Endarterectomy (CEA) and Carotid Artery Stenting (CAS) outcomes have 100% survival rates. This data represents our  fiscal year 2014 ( July 2013- June 2014). 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.

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.

Our stroke neurosurgeons are dual-trained in open neurosurgery and intervention techniques

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 tiny coils 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.
• Pipeline Stent: Our surgeons are the first in Ohio to offer this procedure, involving a flexible mesh tube that can be used to block off aneurysms in the internal carotid artery, a major blood vessel supplying blood to the front of the brain.

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.

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.

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.

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.

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

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.

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.

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.