It was Strike Out Stroke Night at a recent Jacksonville Suns baseball game, and an all-star team was on the field for the opening pitch. But they weren’t baseball players. They’re a part of the Comprehensive Stroke Program at UF Health Jacksonville.

It’s one of the only programs in the region able to treat patients in the ninth inning of a stroke emergency, as late as eight hours after it happens. Most facilities don’t have the highly-trained specialists and cutting-edge equipment required to treat a stroke victim beyond the more traditional three-hour window.

A stroke is the loss of brain function due to a disturbance in the brain’s blood supply.  It causes an incredible 2 million neurons to die every minute. That’s why time is so critical after someone has a stroke.

In the United States, about 800,000 people suffer from strokes every year, and nearly a quarter of strokes occur in people who have had one before. It is the leading cause of an acquired physical disability in American adults, and the fourth leading cause of death. Northeast Florida is on the southeastern edge of a region referred to as the “Stroke Belt,” where strokes are most common in the U.S.

A stroke can be caused by ischemia, which is lack of blood flow commonly due to a clot, or a hemorrhage from burst or bleeding blood vessels in or around the brain. Maintaining control over high blood pressure, heart disease, diabetes, and high cholesterol – and keeping them under control – will greatly reduce your chances of having a stroke. Smoking is also a risk factor.

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
• Sudden confusion, difficulty speaking or difficulty understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden difficulty walking, dizziness or loss of balance or coordination.
• Sudden, severe headache with no known cause.

The Comprehensive Stroke Center’s team includes highly-skilled University of Florida College of Medicine – Jacksonville physicians who have concentrated expertise in treating all types of strokes.

The roster includes:

• Cerebrovascular neurosurgeon Lincoln Jimenez, MD, an assistant professor of neurosurgery who uses a high-tech stent retriever to remove clots from arteries, among other options. He is one of the few surgeons in the region who can perform either an endovascular procedure or open brain surgery depending on what is best for a patient who has suffered a hemorrhagic stroke.
• Neurointensivists Stuart Glassner, DO, and Christopher Hopkins, MD, assistant professors of neurology who work in the Neuroscience Intensive Care Unit to treat the comorbidities that result from a stroke, which can be just as devastating to the body as the stroke itself.
• Neurologist Scott Silliman, MD, an associate professor of neurology who pioneered a system that fosters partnerships between the hospital and EMS personnel so first responders can begin care and communicate with the hospital’s stroke team as soon as they reach the stroke victim.

And that’s just the beginning. The team also includes a corps of expert ICU nurses with specialized neuroscience training; nurse practitioners subspecialized in neuro-critical care; neuroradiologists; a stroke program coordinator; a stroke educator; a dedicated clinical research team; an EMS liaison; and more. The equipment they use is specially designed to evaluate stroke victims. For example, the center has advanced imaging equipment that can rapidly determine the source of a stroke.

Exceeding the national average

The team gets results, with a batting average well above national statistics for stroke treatment. In one of their proudest stats, the team administers triple the national average for intravenous tPA, short for Tissue Plasminogen Activator. 

“When stroke patients come to an emergency department in the United States, only 3 to 5 percent receive IV-tPA nationally. Our number is 15 percent. It might not sound like a lot, but that number is way up there,” Silliman said.

Made up of a protein, tPA, also known as the “clot buster,” breaks down clots. It is critical that it’s delivered as soon as possible to patients once it is determined they are eligible with no contraindications. Having the right equipment to diagnose a patient and the highly skilled specialists who know how to interpret the information saves precious time.

The drug is appropriate for victims of acute ischemic strokes. The UF Health team administers tPA through an IV in the first four-and-a-half hours after a stroke. After that, Jimenez or one of the team’s interventional radiologists can administer catheter-based therapy as late as eight hours after the stroke.

Learn more about the Comprehensive Stroke Program at ufhealthjax.org/stroke.

This article is the first in our five-part Striking Out Strokes series. Click on the links below to read the rest of the series:

Stroke patient grateful for receiving the “clot buster,” IV-tPA

Treating hemorrhagic strokes a different ballgame than ischemic strokes

Neuroradiology is a key component in a stroke emergency

Care after a stroke just as critical as the initial treatment

Featured Faculty

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Scott L. Silliman, MD

Professor
Medical Director, Comprehensive Stroke Program; Program Director, Vascular Neurology Fellowship