Stroke Treatment & Rehabilitation
The neurologists and neurosurgeons at the Cushing Neuroscience Institute Stroke Center within North Shore-LIJ Health System provide the some of the region's most advanced care and treatment for ischemic strokes, hemorrhagic strokes and related neurological conditions.
Stroke treatment at the Cushing Neuroscience Institute Stroke Center includes education about stroke prevention and risk factors, as well the development of a plan of care for those living with the effects of stroke.
Tissue Plasminogen Activator (tPA) is an FDA-approved, clot-busting drug. It must be administered within three hours from the onset of symptoms. To determine if tissue plasminogen activator (tPA) is appropriate for the patient, the doctor must take into account many factors. Some individuals may arrive at the hospital within the three-hour window and not receive this medication for safety reasons.
Antiplatelet agents such as aspirin, clopidogrel (Plavix®), aspirin combined with extended release dipyridamole (Aggrenox®) and anticoagulants such as warfarin (Coumadin®) interfere with the blood’s ability to clot and can play an important role in preventing stroke.
Solitaire™ Flow Restoration (FR)
At North Shore University Hospital's Stroke Center, a US Food and Drug Administration-approved Solitaire™ Flow Restoration (FR) revascularization device is available to patients suffering from acute ischemic stroke. The Solitaire™ FR is a self-expanding, columnar metal cage device combining the ability to restore blood flow to the brain, administer medical therapy and retrieve the blood clot. Treatment with Solitaire™ allows the interventional neurologist to reopen target arteries in a much more effective and efficient way, resulting in less symptomatic intracranial hemorrhage and better neurologic outcomes by three months after the stroke.
Carotid endarterectomy is a procedure in which harmful plaque in the carotid artery is surgically removed. Depending on the type of stroke, location and when the stroke occurred will help determine what type of surgical intervention is appropriate. When stroke is causes by a burst vessel in the brain and blood is causing pressure within the head, a craniotomy may be performed. A craniotomy is a procedure that removes a piece of the bone of the skull so that access to blood is possible and pressure on the brain may be relieved.
Endovascular Stroke Treatment:
A minimally invasive method for treating strokes, endovascular stroke treatment is not offered at all hospitals. For these types of procedures, a catheter is inserted into an artery in the groin and threaded through the body up to the brain where the blockage is occurring. Not everyone is a candidate for an endovascular procedure and your doctor will discuss what is right for you.
Multiple devices are currently available for endovascular stroke therapy and include:
- Standard microcatheter delivery of intra-arterial tPA
- EKOS® EndoWave™ Ultrasound Accelerated Thrombolysis (USAT) System
- The MERCI Retriever®
- Intracranial angioplasty balloons and stents
Two major devices used in stroke management are:
- Solitaire™ FR Revascularization Device is a self-expanding, cylindrical metal cage that is inserted through a small tube into the blood clot itself.
- Penumbra System®, is approved by the FDA for vessel recanalization in stroke. The main component of the system is the reperfusion catheter which utilizes suction to aspirate clots through the device like a vacuum cleaner. A separator, gently extruded in and out of the catheter into the clot, prevents plugging of the reperfusion catheter tip.
Rehabilitation is a critical part of recovery for many stroke patients. The effects of stroke may mean that one must change, relearn or redefine how one lives. Following stroke, a person may have difficulties functioning physically (e.g., unsteady gait, weakness or paralysis), cognitively (e.g., memory, language or perceptual problems) or emotionally (e.g., anxiety and depression).
Stroke rehabilitation helps individuals return to independent living. Each person is unique, and rehabilitation will be tailored to the individual’s specific needs. The comprehensive rehabilitation team can include a rehabilitation doctor (physiatrist), rehab nurse, physical therapist, occupational therapist, speech-language therapist, social worker, neuropsychologist and recreation therapist.
The experts at the Stroke Center utilize a new and exciting technology known as Robodoc®, a robotic device that is being used to assist in the diagnosis and treatment of patients when a physician is not available onsite. Robodoc® can be used in grand rounds, patient assessment and communication as well as a multitude of other tasks.
To make an appointment at the Stroke Center:
Cushing Neuroscience Institute’s Stroke Center makes it easy for you to take the first steps in ensuring the best neurological and neurosurgical care for yourself or your family. Simply email us at firstname.lastname@example.org, call us at (516) 562-3064 or fill out our Request an Appointment form.