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May 2011 | 0 Comments | Print

Board Certification

American Board Of Radiology


Ohio State University


Diagnostic Radiology, Medical College of Virginia Hospitals


Neuroradiology, University of Cincinnati College of Medicine

Community Affiliations

Radiologic Society of North America, American College of Radiology, American Roentgen Ray Society, American Society of Neuroradiology, Ohio State Medical Association, Greater Cincinnati Radiological Society, Cincinnati Academy of Medicine

With stroke, timing is everything

Did you know?

  • 700,000 people in the United States suffer from stroke annually
  • 10 percent of stroke survivors recover almost completely
  • 25 percent recover with minor impairments
  • 40 percent experience moderate to severe impairments requiring special care

10 percent require care in a nursing home or other long-term care facility

Whether you’re talking about prevention, treatment or the incidence of stroke, the numbers tell the story. Stroke is the third-leading cause of death and the No. 1 cause of disability in the United States. Preventing it requires you to keep your cholesterol levels and blood pressure low. And when it comes to treatment, there’s an important number as well – time.  

“Time is of the essence,” says Robert Bulas, M.D., a board-certified neuroradiologist with The Christ Hospital. “There is a three-hour window from the onset of symptoms to treat a stroke with minimal brain damage.”

Stroke is essentially an injury to the brain. Much like a heart attack involves a block in blood flow to the heart, a stroke involves a disruption in blood flow to the brain. It’s sometimes referred to as a “brain attack.” The more time oxygen-rich blood is restricted from the brain, the worse the injury. This is why the faster you recognize the symptoms and get to the ER, the quicker physicians can diagnose and treat you. 

Understanding stroke
The most common type of stroke (ischemic) occurs when a blood clot forms and blocks blood flow to the brain. Clots are more common in people who smoke or have diabetes, high blood pressure, high cholesterol, heart disease and a family history of stroke. Symptoms can include a sudden onset of:

  • Slurring or difficulty speaking
  • Confusion
  • Numbness or weakness of the face, arm or leg, especially on one side of the body
  • Loss of vision
  • Dizziness
  • Loss of balance
  • Acute onset of a severe headache.

“Get to the emergency room if you have any of these symptoms, even if they last only for a few minutes and then resolve,” Dr. Bulas says.

Mini-stroke, maximum attention
Even subtle warning signs shouldn’t be ignored; they could be an indication of more serious problems. A transient ischemic attack, or TIA, is considered a “mini-stroke,” and can briefly produce symptoms similar to an actual stroke, but without permanent brain damage. Consider TIAs a warning sign; they are typically precursors to an actual stroke. “In any case, these are still brain attacks and should be treated as emergencies,” Dr. Bulas says.

Timely treatments minimize damage
Anyone presenting with stroke symptoms at The Christ Hospital will quickly undergo a CT scan of the brain to differentiate between an ischemic and hemorrhagic (bleeding of the brain) stroke and determine the course of treatment.

If blood flow to the brain is restricted, doctors may administer a clot-busting drug called tissue plasminogen activator (t-PA), which dissolves clots in the blood vessel. “These blood thinners are most effective at restoring blood flow and saving the brain when given within three hours of the onset of symptoms,” Dr. Bulas says. “In other words, get to the ER fast.”

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