Danbury Hospital Stroke Center Offers Comprehensive Care

By Kendra Bobowick

From Dr Neil Culligan’s description of a stroke emerges a picture of a spontaneous and debilitating affliction. He said, “It’s a devastating disease. Patients are normal, and within seconds they are disabled.” Danbury Hospital sees as many as 400 stroke patients annually, offering a grim average of at least one person a day succumbing to a stroke.

Patients now benefit from an accredited and more comprehensive program since the hospital has become a nationally certified stroke center in operation.

Chief of Neurology at Danbury Hospital and a Newtown resident, Dr Culligan has been anticipating this achievement for nearly a decade, and has brought his department through the certification for treating stroke.

Explaining his push for the center, Dr Culligan said, “I felt strongly that a more coordinated approach was needed for [a patient’s] overall outcome and for the family.” Dr Culligan explained, “For ten years I have wanted to start a stroke program at the hospital. In order to get the certification we had to make a lot of changes.”

Both he and Heather Duggan, RN, have important roles in the center. Specifically, he was appointed the Danbury Hospital Stroke Center’s director, while Ms Duggan was appointed stroke coordinator.

Stroke patients require attention from many medical professionals, which Dr Culligan, for one, aimed to coordinate. “Stroke affects every system in the body and many physicians and many disciplines are needed to care for them,” he said.

With a stroke center in place, the hospital now possesses treatment advantages.

“We now have dedicated personnel, stroke care pathways and guidelines, and have a Stroke Improvement Performance Committee that meets monthly,” Dr Culligan said. Medical staff can respond more quickly and comprehensively, more safely, and have more to offer after the stroke, he explained. He said the stroke center embodies thorough care, “geared toward complex conditions with careful care and careful guidelines — it’s not something new you can buy; it’s complicated.”

Getting Treatment ASAP

Adding to the enhanced care are measures of education and treatment for victims before they get to the hospital. Dr Culligan explained that public education about how to prevent stroke and recognizing the signs of stroke are part of the larger picture of treating the illness.

He said, “We want people to call 911 with symptoms and want them to get to the hospital as soon as possible.” In fact, some people delay seeking help when signs occur. Sudden onset of numbness, weakness, visual loss, and trouble speaking are stroke indicators, he said.

“Many people ignore [them] and go to bed and think they will deal with it in the morning,” he said. “Because [symptoms] are not painful, they don’t react.”

Aside from educating the public on the necessity of a prompt response, the emergency medical teams responding to the 911 calls also play a critical role.

“The next step is getting the EMS to realize the signs of stroke and notify the hospital they are coming in with a stroke patient,” Dr Culligan said.

Time is a critical aspect of stroke treatment for several reasons. Only one federally approved drug exists for acute stroke — the primary form of stroke where too little blood gets to the brain — and the drug must be administered within hours of symptoms.

Dr Culligan was referring to tissue plasminogen activator (tPA), which is a strong blood thinner.

“In order to use this, you need to give it within three hours of the start of symptoms,” Dr Culligan said. Only a small percentage of patients will be eligible to receive the tPA, however. “There is significant risk of causing bleeding in the brain,” he said.

The tPA treatment “is a small part of the pie,” said Dr Culligan. The stroke center has other advantages. “We also have guidelines in place for care of a patient throughout the hospital stay.”

Programs are also in place to monitor a patient and coordinate rehabilitation care. Overall, the center is a continuum of care, Dr Culligan said. The care does not end when a patient leaves the hospital. “We will work with you in the hospital and look at setting up long-term care after discharge,” he said.

Conscientious health care can address certain risk factors. Control high blood pressure, for example, and see a primary care doctor, said Dr Culligan. He also noted that diet and exercise changes could be coordinated with a doctor’s care. Smoking and high blood pressure both reduce blood flow, he warned.

 

What Is A Stroke?

Acute ischemic stroke occurs when an artery to the brain is blocked, according to strokecenter.org. The site also indicates that ischemic stroke is by far the most common, accounting for about 88 percent of all strokes.

More information available at emedicine.com indicates that stroke — the clinical term for acute loss of circulation to an area of the brain — is classified as either hemorrhagic or ischemic.

According to Americanheart.org, both the American Heart Association and the American Stroke Association “strongly urge people to seek medical attention as soon as possible if they believe they’re having a stroke or heart attack. The sooner tPA or other appropriate treatment is begun, the better the chances for recovery.

“Tissue plasminogen activator (tPA) is a thrombolytic agent (clot-busting drug). It’s approved for use in certain patients having a heart attack or stroke. The drug can dissolve blood clots, which cause most heart attacks and strokes.”

The strokeassociation.org states that blood flow to the brain tissue can be hampered in two ways resulting in (ischemic stroke) where the vessel clogs, or (hemorrhagic stroke) where the vessel ruptures, causing blood to leak into the brain.