Medical Minute 12-9: Putting Strokes on Ince

By: Andrew McIntosh Email
By: Andrew McIntosh Email

Lena and Clifford Hooe began their life together with a kick-kick-turn and slide. It's been 20 years and they've never stopped dancing.

"He's energetic, he's like a little boy."

From tennis, to Tae Kwan Do, Clifford lives to learn. He was off to kick boxing class when he was hit with the unexpected.

"He had fallen and he said I can't get up," said Lena Hooe, Clifford's Wife.

"Oh no, not me. Please."

Doctors treated this first stroke with drugs-- Clifford recovered completely, but then-a second stroke.

"It can't be happening again. It just can't."

Clifford was paralyzed on his left side. Doctors at Cedars Sinai used hypothermia to cool his body -stopping inflammation and slowing his metabolism-allowing his brain time to rest.

"If we begin to cool them within six hours, we have the chance for a complete salvage," said Patrick D. Lyden, M.D., Chair, Department of Neurology.

An ice cold device sits in the body's largest vein and cools the blood directly.

"We put a catheter inside the body and cool the blood stream from inside out."

The body's cooled to 33 degrees for 24 hours. Then..it's slowly brought back to normal temperature. Doctor Patrick Lyden says next to clot-busting drugs,

"I view hypothermia as the second biggest breakthrough of our lifetime."

Although this stroke slowed Clifford down-without the hypothermia treatment, things could have been much worse. He's thankful for his doctors and his dancing partner.

"I want to hold my wife tight and give her a big kiss for all she's done for me."

For more information on other series produced by Ivanhoe Broadcast News contact John Cherry at (407) 691-1500, jcherry@ivanhoe.com.

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MEDICAL BREAKTHROUGHS - RESEARCH SUMMARY:

BACKGROUND: A stroke occurs when blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. Within minutes, brain cells begin to die.
A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications. A stroke can cause temporary or permanent disabilities, depending on how long the brain suffers lack of blood flow and which part was affected. Complications may include: paralysis or loss of muscle movement, difficulty talking or swallowing, memory loss or trouble with understanding, pain, numbness or other strange sensations and changes in behavior and self-care. (mayoclinic)

HYPOTHERMIA TREATMENT: Brain cooling has been shown to decrease brain swelling and reduce loss of neurologic function after an acute stroke. It has also been proven highly effective in saving lives and preventing neurologic damage after cardiac arrest and after oxygen deprivation in newborns.

Cooling is achieved by inserting a special catheter into the inferior vena cava. No fluid enters the patient; instead, an internal circulation within the catheter transfers heat out. Study participants are covered with a warming blanket to “trick” the body into feeling warm, and temperature sensors in the skin and a mild sedative help suppress shivering. At the conclusion of the cooling period, participants will be re-warmed over 12 hours.

Researchers believe that hypothermia may be beneficial while a stroke is happening. In particular, hypothermia may make it possible to use tPA later than 3 hours after a stroke begins.

Tissue plasminogen activator (tPA)—a naturally occurring protein - activates the body's ability to dissolve recently formed blood clots and reduces or prevents the brain damage caused by a stroke. The FDA has approved the use of tPA for people having a stroke when taken within 3 hours of stroke onset, but not for those who arrive at the hospital more than 3 hours after. (www.cedars-sinai.edu, www.clinicaltrials.gov)

DR. LYDEN & CEDARS-SINAI: Cedars-Sinai is a regional stroke referral center for complicated cases. The Stroke Program has received the Gold Award from the American Stroke Association, is certified as a Primary Stroke Center by The Joint Commission and is an Approved Stroke Center of Los Angeles County’s Emergency Medical Services Agency. Lyden, the Chair in Neurology at Cedars-Sinai, is principal investigator of the “ICTuS” (Intravascular Cooling in the Treatment of Stroke) trials evaluating post-stroke hypothermia therapy. He was one of the key researchers in the major clinical trial leading to Food and Drug Administration approval in 1996 of tPA – which remains the only proven and approved drug for stroke treatment. (www.cedars-sinai.edu)

FOR MORE INFORMATION, PLEASE CONTACT:

Sandy Van
Media Relations
Cedars-Sinai Medical Center
(808) 526-1708
sandy@prpacific.com


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