The University of Utah Stroke Center is a national, DNV-accredited leader in comprehensive stroke care. We are a dedicated team specializing in stroke treatment and available 24/7 for our patients. Our center offers an accredited specialty stroke rehabilitation program as well as providing care to rural and underserved areas via Telestroke (telemedicine).

If you recognize signs of a stroke, call 911 immediately.

Overview of Stroke

What is stroke?

Stroke, also called brain attack, occurs when blood flow to the brain is disrupted. Disruption in blood flow is caused when either a blood clot or piece of plaque blocks one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke).

The brain needs a constant supply of oxygen and nutrients in order to function. Even a brief interruption in blood supply can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen. The area of dead cells in tissues is called an infarct. Due to both the physical and chemical changes that occur in the brain with stroke, damage can continue to occur for several days. This is called a stroke-in-evolution and requires close observation. 

A loss of brain function occurs with brain cell death. This may include impaired ability with movement, speech, thinking and memory, bowel and bladder, eating, emotional control, and other vital body functions. Recovery from stroke and the specific ability affected depends on the size and location of the stroke. A small stroke may result in problems such as weakness in an arm or leg. Larger strokes may cause paralysis (inability to move part of the body), loss of speech, or even death.

According to the National Stroke Association, it is important to learn the 3 Rs of stroke:

  • Reduce the risk.

  • Recognize the symptoms.

  • Respond by calling 911 (or your local ambulance service).

Stroke is an emergency and should be treated as such. The greatest chance for recovery from stroke occurs when emergency treatment is started immediately.

Risk Factors for Stroke

Risk factors are those things that increase your chance of having a certain disease, like a stroke. Some risk factors can't be changed, like your sex or age. Some risk factors can be changed, like overweight or lack of exercise. 

Risk factors in women and men

There are differences between stroke risk factors in men and women. Some stroke risk factors:

  • Only affect women. Examples are pregnancy or having diabetes during pregnancy (gestational diabetes)

  • Occur in both men and women, but are more likely to lead to stroke in women. Examples are diabetes and high blood pressure (hypertension).

  • Affect both men and women in about the same way. Examples are your age and smoking.

Women-only risk factors for stroke

Some risk factors can only occur if you are a woman. They are:

  • Being pregnant

  • Preeclampsia, a condition with high blood pressure when you are pregnant

  • Gestational diabetes

  • Taking birth control pills

  • Taking hormone replacement after menopause

  • Changing hormone levels

  • Stroke risk factors in women and men

These risk factors occur in both women and men, but are more likely to increase the risk of stroke in women:

  • Migraine headache with aura, a severe headache with certain symptoms just before the headache

  • Atrial fibrillation, a fast, irregular heartbeat

  • Diabetes mellitus

  • High blood pressure

  • Depression

  • Stress

Stroke risk factors in women and men

These risk factors increase the risk of stroke in both women and men:

  • Being inactive

  • Older age

  • Previous heart and blood vessel (cardiovascular) disease

  • Being overweight

  • Unhealthy diet (for example, high in fat, cholesterol, and sugar; low in fruits, vegetables, grains, nuts, and olive oil)

  • Smoking

  • Metabolic syndrome, a group of findings and lab test results that increase the chance of stroke, heart attack, and diabetes

The abnormal lab results and findings include blood sugar, cholesterol and triglycerides, blood pressure, and overweight

Talk with your health care provider about your risk factors and what you can do to lower your risk of stroke.  

Treatment for Stroke

Medical treatment for stroke

Specific treatment for stroke will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Severity of the stroke

  • Location of the stroke

  • Cause of the stroke

  • Your tolerance for specific medications, procedures, or therapies

  • Type of stroke

  • Your opinion or preference

Although there is no cure for stroke once it has occurred, advanced medical and surgical treatments are now available, giving many stroke victims hope for optimal recovery and reducing the risk of another stroke.

Emergency treatments for stroke

Treatment is most effective when started immediately. Emergency treatment following a stroke may include the following:

  • Medications used to the dissolve blood clot(s) that cause an ischemic stroke. Medications that dissolve clots are called thrombolytics or fibrinolytics and are commonly known as "clot busters." These drugs have the ability to help reduce the damage to brain cells caused by the stroke. In order to be most effective, these agents must be given within 3 hours of a stroke's onset, so get to the emergency department as quickly as possible.

  • Medications and therapy to reduce or control brain swelling. Special types of intravenous (IV) fluids are often used to help reduce or control brain swelling, especially after a hemorrhagic stroke (a stroke caused by bleeding into the brain).

  • Medications that help protect the brain from damage and ischemia (lack of oxygen). Medications of this type are called neuroprotective agents, with some still under investigation in clinical trials.

  • Life support measures, including such treatments as ventilators (machines to assist with breathing), IV fluids, adequate nutrition, blood pressure control, and prevention of complications

Other medications used to treat or prevent a stroke

Other medications that may help with recovery following a stroke, or may help to prevent a stroke from occurring, include the following:

  • Medications to help prevent more blood clots from forming. Medications that help to prevent additional blood clots from forming are called anticoagulants, as they prevent the coagulation (clotting) of the blood. Medications of this type include, for example, heparin and warfarin and enoxaparin.

  • Medications that reduce the chance of blood clots by preventing platelets (a type of blood cell) from sticking together. Examples of this type of medication include aspirin, clopidogrel or dipyridamole.

  • Medications to treat existing medical conditions, such as diabetes, heart, or blood pressure problems.

    • These are numerous and your doctor(s) will develop a plan of care to include all your diseases. 

Types of surgery to treat or prevent a stroke

Several types of surgery may be performed to help treat a stroke, or help to prevent a stroke from occurring, including the following:

  • Carotid endarterectomy. Carotid endarterectomy is a surgical procedure used to remove plaque and clots from the carotid arteries, located in the neck. These arteries supply the brain with blood from the heart. Endarterectomy may help prevent a stroke from occurring.

  • Carotid stenting. A large metal coil (stent) is placed in the carotid artery much like a stent is placed in a coronary artery. The femoral artery (in your groin area) is used as the site for passage of a special hollow tube to the area of blockage in the carotid artery. This procedure is often done in radiology labs, but may be performed in the cath lab.

  • Craniotomy. A craniotomy is a type of surgery in the brain itself to remove blood clots, relieve pressure, or repair bleeding in the brain.

  • Surgery to repair aneurysms and arteriovenous malformations (AVMs). An aneurysm is a weakened, ballooned area on an artery wall that has a risk for rupturing and bleeding into the brain. An AVM is a congenital (present at birth) or acquired disorder that consists of a disorderly, tangled web of arteries and veins. An AVM also has a risk for rupturing and bleeding into the brain. Surgery may be helpful, in this case, to help prevent a stroke from occurring. The surgery may involve surgical clips placed on aneurysms to prevent them from rupturing (and thus causing life-threatening bleeding in the future) or tiny coils curled up inside the aneurysm. The coils are placed inside the aneurysm through a special catheter advanced mechanically through the arteries of the body from a puncture site, usually through the large artery located in the groin. An AVM may be treated not only surgically, but also through the use of new chemical substances commonly called glues, which clot off some of the blood vessels that are part of the AVM. Special energy waves known as gamma waves are part of a relatively new mode of radiosurgery, in which part of an AVM can be scarred (and thus prevented from bleeding in the future) by use of a tool known as a "gamma knife" or a "cyber knife." 

  • Patent foramen ovale (PFO) closure. The foramen ovale is an opening that occurs in the wall between the 2 upper chambers of a baby's heart before birth. It functions to provide oxygen-rich blood to the baby from the mother's placenta while in the womb. This opening normally closes soon after birth. If the flap does not close, blood flows from the right atrium directly to the left atrium (atriums are the top chambers of the heart). It then flows out to the central circulation of the body. If this blood contains any clots or air bubbles, they can pass into the brain circulation causing a stroke or transient ischemic attack (TIA). PFO closure procedure can be performed through a percutaneous (through the skin) approach. Signs and symptoms of a PFO may not occur until early or middle adulthood and may even go undetected. Currently, it is controversial as to whether a PFO ought to be closed, and current research studies are still trying to determine when and under what circumstances this should be done.

Constraint-Induced Therapy (CIT) for arm and hand paralysis after stroke

Many individuals who have a stroke are left with paralysis of the upper extremities. CIT is a treatment that encourages the use of the stroke-affected limb by constraining the nonaffected limb in a mitt, sling, splint or glove. Intense exercises are done using the stroke-affected arm or hand.

  • CIT restraints are worn for up to 90% of the waking hours.

  • Restraints can be removed for activities, such as bathing.

  • Small steps are used to break down complex tasks, such as making a phone call.

  • Verbal and written feedback is used to help motivate and inform people undergoing CIT.

Specialties:

General Neurology, Stroke, Vascular Neurology

Locations:

A location has not yet been added by this physician.

L. Dana DeWitt, M.D.

L. Dana DeWitt, MD is Medical Director for the Inpatient Neurology Service at University Hospital. She is also a member of the Brain Attack Team and interprets transcranial Doppler. She has had the honor of receiving awards as Best of Boston Magazine’s Top Docs for Women, Consumers’ Checkbook Top Docs, and Best ... Read More

Specialties:

General Neurology, Multiple Sclerosis, Neurology, Stroke, Transcranial Dopplers, Vascular Neurology, White Matter Disease

Locations:

Clinical Neurosciences Center (801) 585-7575
Imaging and Neurosciences Center (801) 585-7575

Specialties:

Neurology, Vascular Neurology

Locations:

Clinical Neurosciences Center (801) 585-7575

Jennifer Juhl Majersik, M.D., M.S.

Dr. Majersik is an Associate Professor of Neurology at the University of Utah, School of Medicine. After receiving her B.S. in Physics from Harvey Mudd College (Claremont, CA), she served in the Air Force as a Scientific Analyst at Wright-Patterson Air Force Base National Air Intelligence Center. In 1997, she at... Read More

Specialties:

Hereditary Hemorrhagic Telangiectasia, Neurology, Stroke, Vascular Neurology

Locations:

Clinical Neurosciences Center (801) 585-7575

Min S. Park, M.D.

Dr. Park is a neurosurgeon who comes to University of Utah Health Care from the Barrow Neurological Institute in Phoenix, where he recently completed a fellowship in endovascular neurosurgery. He completed his neurosurgery residency at the UC San Diego Medical Center. Following graduation, he served on active du... Read More

Specialties:

Brain Tumors, Cerebral Aneurysms, Hydrocephalus, Neurointerventional Radiology, Neurosurgery, Neurovascular Surgery, Skull Base Surgery, Stroke, Trauma - Neuro Critical Care, Traumatic Brain Injury, Vascular Malformations, Vascular Neurology

Locations:

Clinical Neurosciences Center (801) 585-6065

Phil Taussky, M.D.

Phil Taussky, MD was born in Basel, Switzerland where he earned his MD degree at the University of Basel. During his residency at the Kantonsspital Aarau, Switzerland, he was also one of the team physicians for the Swiss National ice-hockey team. After his residency he completed a skull base/cerebrovascular fell... Read More

Specialties:

Brain Tumors, Cerebral Aneurysms, Hydrocephalus, Neurointerventional Radiology, Neurosurgery, Neurovascular Surgery, Skull Base Surgery, Stroke, Trauma - Neuro Critical Care, Traumatic Brain Injury, Vascular Malformations, Vascular Neurology

Locations:

Clinical Neurosciences Center (801) 581-6908

Jana Wold, M.D.

Jana Wold, MD is an Assistant Professor of Neurology and board certified in Neurology and Stroke. Her inpatient clinical practice includes evaluating and treating acute stroke patients in the hospital and emergency department as part of the Brain Attack team, and over the camera through the use of telemedicine. ... Read More

Specialties:

Neurology, Stroke, Vascular Neurology

Locations:

Clinical Neurosciences Center (801) 585-7575

Adam de Havenon, M.D.

Dr. de Havenon is an Assistant Professor of Neurology at the University of Utah, School of Medicine. After receiving his B.A. from Yale University (New Haven, CT) in 201, he received his medical degree from Brown University School of Medicine in 2009 (Providence, RI) and complete internship and neurology reside... Read More

Specialties:

Stroke, Vascular Neurology

Locations:

A location has not yet been added by this physician.

University Campus/Research Park

Clinical Neurosciences Center 175 N. Medical Drive
Salt Lake City, UT 84132
Map
(801) 585-7575
Imaging & Neurosciences Center 729 Arapeen Drive
Salt Lake City, UT 84108
Map
(801) 585-7575
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  • Advancing Telestroke Care
    Keywords: Ischemic Stroke, Outcome, Telemedicine, Control
    Status: Active, not recruiting
  • CLEAR III
    Keywords: Intraventricular hemorrhage, Intracerebral hemorrhage, placebo, tPA, Extraventricular, Hemorrhegic Stroke
    Status: Recruiting
  • The REDUCE Trial
    Keywords: Heart, PFO, Occluder
    Status: Recruiting
  • GAMES-RP
    Keywords: Acute Stroke
    Status: Recruiting
  • Sock Study
    Keywords: stroke, balance
    Status: Not yet recruiting
  • SHINE
    Keywords: Acute Ischemic Stroke, Glucose Management, GlucoStabalizer
    Status: Recruiting
  • Memantine for Enhanced Stroke Recovery
    Keywords: Stroke, Memantine, Motor Recovery, Rehabilitation
    Status: Recruiting
  • IRIS
    Keywords: Ischemic Stroke, Insulin Resistnace, Thiazolidinedione, placebo
    Status: Active, not recruiting
  • Dysport LowerLimb-Double Blind (140)
    Keywords: Spasticity, Stroke, TBI
    Status: Completed
  • GOCHA
    Keywords: Coumadin, Hemorrhegic Stroke, Genetic analysis, Control
    Status: Active, not recruiting
  • Sildenafil and Stroke
    Keywords: stroke, rehabilitation, motor skills, sildenafil
    Status: Not yet recruiting
  • Gablofen 3mg/mL
    Keywords: ITB Pump, Muscle Spasticity
    Status: Completed
  • Athersys B01-02
    Keywords: Acute Ischemic Stroke, MultiStem
    Status: Active, not recruiting