Stroke

We also invite you to watch our livestream, "When Stroke Happens: What to Do" featuring our co-directors of the Cerebrovascular and Comprehensive Stroke Center, Dr. David Fiorella and Dr. Michael Guido.

Ischemic and Hemorrhagic Strokes 

The outlook for people who have had a stroke is more hopeful than ever today due to advances in stroke awareness, prevention, treatment, education and rehabilitation. However, stroke remains the fifth-leading cause of death for both men and women in the United States.There are two general categories of stroke – ischemic and hemorrhagic. Stony Brook Medicine has experts in the treatment and diagnosis of both kinds of stroke.

• Ischemic stroke: An ischemic stroke occurs when an artery that supplies blood flow to the brain becomes blocked or severely narrowed (or “stenotic”). Blockage of a brain artery can result from a blood clot traveling from someplace else in the circulatory system (“a thromboembolus or embolus”). It can also result from plaque build up in the brain artery itself (i.e., “hardening of the arteries” or “intracranial atherosclerotic disease”), which causes a narrowing of the artery.
• Hemorrhagic stroke: Refers to any condition resulting in bleeding within or around the brain. Bleeding within the brain can be caused by high blood pressure (a hypertensive hemorrhage), blood-thinning medications, from underlying disease in the brain’s small blood vessels (e.g., amyloid angiopathy) and from brain aneurysms and vascular malformations (e.g., AVMs, cavernous malformations).

The Comprehensive Stroke Center Difference

In May 2018, Stony Brook University Hospital became the first hospital in Suffolk County to achieve Comprehensive Stroke Center (CSC) certification by The Joint Commission, the nation's oldest and largest standards-setting and accrediting body in health care. This is the highest level a stroke center can achieve, and involves a rigorous screening process. The advanced Comprehensive Stroke Center designation indicates our ability to receive and treat the most complex stroke cases. As a certified comprehensive stroke center, Stony Brook provides nationally recognized best practices and a level of care few hospitals anywhere can match. Nationally approximately only 200 hospitals out of 5,800 have earned this certification.

To be eligible, hospitals must first demonstrate compliance with stroke-related standards.  Ou center had been a New York State Department of Health designated Stroke Center since 2005 and a Joint Commission-certified Advanced Primary Stroke Center since 2004. Additional requirements include:

• Advanced imaging capabilities (Stony Brook offers magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA), computed tomography angiography (CTA), digital subtraction angiography (DSA), and transcranial doppler ultrasound (TCD)
• 24/7 availability of specialized treatments, operating room and endovascular facilities and staff with the unique education and competencies to care for complex stroke patients (training in vascular neurology, neurosurgery and endovascular procedures)
• Experience and expertise in treating volume of patients with large ischemic strokes, intracerebral hemorrhage and subarachnoid hemorrhage
• Ability to deliver physical, occupational and speech therapy every day of the week
• Follow up with patients on their outpatient care
• Community education outreach to local residents about preventing and recognizing strokes
• Tracking performance and defined quality improvement programs to maximize positive outcomes of stroke patients, especially for the most complicated cases

All of these requirements and measures are designed to help hospital teams create a loyal and cohesive clinical team, establish a consistent approach to care, reduce the variation and risk of error, and demonstrate a commitment to a higher standard of clinical service.