Lifesaving Stroke Care Is About Time

Fast action by Inova Alexandria Hospital puts stroke patient on a path to full recovery 

Donald Folk, 55, loves tight turns on ski slopes, spiking volleyballs and pretty much any sport that gets the heart pumping. To help stay fit, he walks — briskly — and usually along the Potomac River’s Mount Vernon trail in Old Town Alexandria. For some reason, last year on Christmas morning, this Alexandria resident changed his routine. “I decided to stay on the main streets,” he recalls. “That decision probably saved my life.”

Doctors likely would agree. After Donald finished his morning walk, he strolled into a convenience store for a soda. Once back outside, his drink fell from his hand and he collapsed. “I vaguely remember someone stopping to help me and then calling 911,” he says. “If I’d been down by the river, on Christmas morning, I doubt anyone would have been around to call for help.”

Between the bystander’s quick wits and the EMS responders’ fast action, Donald was soon at the Inova Alexandria Hospital (IAH) Emergency Department (ED). Upon arrival, he was taken immediately for a CT scan, which confirmed that he was having an ischemic stroke. The ED team quickly administered tPA, a clot-busting drug that helps restore blood flow to the brain — but only if administered within four-and-a-half hours of stroke onset. In this case, time was on Donald’s side.

Based on the severity of Donald’s stroke, an additional specialized CT scan was performed that confirmed blockage of his right carotid artery. Upon discussion with the ED team and review of the imaging, interventionalists Kenneth Rholl, MD, and Venu Vadlamudi, MD, then activated the interventional stroke team consisting of doctors, technologists, nurses and anesthesiology experts. Within minutes, they had Donald on the table and removed the blockage, restoring blood flow to his brain. A severe narrowing of his artery turned out to be cause for his stroke, so a stent was placed to keep the artery open.

Why all this highly choreographed fast action? “Time is brain,” explains Dr. Vadlamudi, Medical Director of the Stroke and Cerebrovascular Disease Program at IAH. “The quicker we restore blood flow to the brain, whether with tPA or a procedure, the less risk there is for permanent brain damage, and the patient has a significantly better chance for a good outcome at 90 days and beyond. That’s why it’s so important to know the signs of stroke and if you see them, to immediately call 911.”

Donald is living proof of the value of acting fast. “I’ve been taking my morning walks for a while now, and I just started taking my nighttime walks along the river, which is my favorite thing to do,” he says.

Time Is Brain
Learn more about stroke and cerebrovascular care.