A stroke occurs when something blocks or reduces the blood supply to part of your brain. This prevents your brain tissue from getting oxygen and nutrients. This can result in brain damage, paralysis and other life-altering complications.

There are 2 main types of strokes: 

• Ischemic stroke: caused by a blocked artery
• Hemorrhagic stroke: caused by a ruptured blood vessel 

If you have a stroke, you need medical care right away. Early care can decrease damage and improve outcomes. 

Sometimes, stroke symptoms go away after a few minutes. This is a transient ischemic attack (TIA), or "mini-stroke." It's a temporary block in blood flow to the brain. 

If you have a TIA, you need medical care right away. It can come back or cause a stroke. It shouldn't be ignored. Call 9-1-1 or go to the ER right away if you suspect you've had a TIA. 

Anyone with a stroke or TIA needs ER care as soon as possible. Treatment starts in the ambulance on the way to the hospital. After initial treatment, you may have changes in your abilities that need more care. 

These changes may include:

• Physical changes: Weakness or paralysis on one side of the body, difficulty gripping, or slowed ability to communicate, problems with bladder and bowel control
• Cognitive changes: Problems with memory, judgment, problem-solving, or concentration
• Speech abilities: Difficulty speaking or slurred speech
• Vision changes: Decreased field of vision, trouble with depth perception, or inability to locate body parts
• Behavior changes: Impulsivity, inappropriate words or actions, loss of emotional control or depression
• Sensory changes: Loss of sight, hearing, smell, touch, or taste 

When you've survived a stroke, you'll need both post-acute and long-term care. Post-acute rehabilitation can prevent further brain damage and improve results. 

Most recovery occurs in the first weeks and months after a stroke. But you can continue to improve even 12 to 18 months later. 

You may need more post-stroke treatment for complications like paralysis or upper extremity weakness.

We provide total stroke care. This begins in the ER and continues through post-acute and chronic care. 

Acute care

At Carilion, acute stroke care happens all day, every day. When you arrive at a Carilion ER with a stroke, you get care right away from our expert stroke team. If you're in a community hospital ER, they'll activate the Telestroke network to consult a stroke neurologist on the best course of care. 

The Telestroke expert may recommend drug treatment at the community hospital where you are. Or they may say to transfer you to Carilion Roanoke Memorial Hospital for other treatment. 

Our rapid response times are an essential part of our effective stroke care.

Treatment for ischemic stroke 

Acute treatment for ischemic stroke is often medicine:

• Tissue plasminogen activator (TPA) dissolves a blood clot, but only if you get it within 4 hours of symptoms starting. The sooner you can get it, the better.
• If you cannot get TPA, other medicines can stop blood from making more clots. And blood thinners can keep existing clots from getting bigger.
• In other cases, a mechanical thrombectomy is your best option. This removes the blood clot from the artery in the brain. It's minimally invasive, using tools on a thin wire threaded through your blood vessels.

Treatment for hemorrhagic stroke 

Acute treatments for hemorrhagic stroke focus on stopping the bleeding. The first step is to find the cause of bleeding in the brain. Causes include:

• Ruptured aneurysm: When a bulging wall of a blood vessel bursts open
• High blood pressure: Can damage blood vessels inside the brain, causing bleeding
• Vascular issues, like arteriovenous malformation (AVM): A tangle of arteries and veins that can bleed in the brain

To control a ruptured aneurysm, you may need a procedure to prevent further leaking of blood. It also can help prevent the aneurysm from bursting again.

• Microvascular clipping: A metal clip placed on the aneurysm to block blood flow
• Endovascular coiling: Inserting coils into the aneurysm to block blood flow
• Flow diversion: Placing a stent to redirect blood away from a large aneurysm

If high blood pressure is the cause of bleeding, you may get blood pressure medicines.

If your stroke was due to an AVM, you may need it repaired with:

• Surgery
• An injection into the blood vessels to block blood flow
• Radiation to shrink the blood vessels

After the ER, you'll get your acute treatment in our intensive care unit (ICU) or our neuro ICU, which provides expert care for critical cases.

Post-acute rehabilitation 

After the acute phase, you'll transition to a post-acute care program that best meets your needs. We have 3 different types: 

• Acute rehab program: You may go to Carilion's Inpatient Physical Rehabilitation floor, which is staffed by acute rehab care experts
• Subacute rehab and chronic care: You may go to a subacute rehab setting or skilled nursing facility for intensive therapy
• Outpatient rehab: You may continue rehab at home or in a rehab center to refine your motor skills

Wherever you get rehab, it'll likely include working with many experts. They include:

• Speech therapy: Helps with problems producing or understanding speech
• Physical therapy: Helps you relearn movement and coordination skills using exercises
• Occupational therapy: Helps you relearn daily activities, such as eating, drinking, dressing, bathing, reading, and writing

Our integrated clinic appointments ensure seamless follow-up care. 

Even years after a stroke, you may need continued rehab.

One newer treatment we offer at Carilion is the Enhanced Stroke Recovery Program. The program pairs a vagus nerve stimulation (VNS) implant with occupational therapy. This combination can improve your arm and hand function, even years after a stroke.

The doctors surgically implant the VNS in the neck. It helps enhance neuroplasticity in the brain, making rehab therapies more effective and improving outcomes.

We also actively recruit for stroke clinical trials to help you access new treatments.