Our Community

Share

You’re the Doctor

By Joseph P. Broderick, MD
Research Director, UCNI

1. The two scans below show the head of the same patient, who suffered an acute stroke (image at left). Members of the Greater Cincinnati/Northern Kentucky Stroke Team reopened a blocked artery in the patient’s brain with t-PA, a clot-busting medicine (right). If the blocked artery can be opened quickly enough, the restoration of blood flow can salvage damaged brain tissue. If reopening occurs too late, brain tissue will die, even if blood flow is restored. In such situations the patient will have a poorer recovery or may die.

Current national guidelines state that t-PA must be administered within how many hours after onset of stroke symptoms?

1)      8 hours
2)      6 hours
3)      4 ½ hours
4)      3 hours
5)      2 hours
(Answer at bottom of page)

2. The two CT images show the head of the same patient, 41⁄2 hours apart. The patient came to the emergency department following a sudden onset of weakness on the left side and become much more poorly responsive during the 41⁄2 hours between scans.

What is the diagnosis?

  1. Large malignant brain tumor
  2. Large ischemic stroke (dead brain from not enough blood)
  3. Large area of encephalitis
  4. Large brain hemorrhage

Clue: The bone of the skull is the most dense and appears very white on a CT scan; brain tissue is less dense and appears gray; cerebrospinal fluid is the least dense and is dark. One other substance in the body is denser than brain tissue but not as dense as bone.

(Answer at bottom of page)

Change Your Brain, Change Your Life

Below is a video of Dr. John Tew’s Oct. 6, 2009 presentation, “Change Your Brain, Change Your Life,” to the Tocqueville Society, a leadership arm of United Way of Greater Cincinnati.

*Video:john m. tew, md

You’re the Doctor Answers

1. 4½ hours.  And the chance for an excellent outcome dramatically increases the earlier one can administer t-PA after symptoms first start.
2. Large area of encephalitis.

  • Print This Page
  • Make an Appointment: Schedule Now
  • Sign up for our newsletter!
  • UCNI Weekly Blog
  • Hope Stories

    • Christine’s Story: Stroke

      Christine's Story: StrokeThere was a sliver of a chance, maybe, and most likely the emergency room doctor thought there was no chance at all. Christine had arrived at the community hospital comatose, brought by her parents, who had come home after working...
    • Alison’s Story: Ruptured Aneurysm following Neurotrauma

      Alison's Story: Ruptured Aneurysm following Neurotrauma Step by hard-earned step, word by remembered word, Dr. Alison Delgado has recovered from a bicycle accident that nearly robbed her of her life. Dr. Delgado, who suffered serious physical and neurological injuries in the 2010 accident, is today a...
    • Dick’s Story: Ischemic Stroke

      Dick's Story: Ischemic Stroke As a firefighter who attends regular EMS drills, Dick Koeniger was well versed in the signs and symptoms of stroke. While driving home with a friend one evening last June, he suddenly noticed that his peripheral vision was slightly impaired....
    • Mary Ann’s Story: Cervical Dystonia

      Mary Ann’s Story: Cervical Dystonia Mary Ann, a registered nurse, was the first to notice that her head was tilting ever so slightly to the left. She was able to ignore it for a while, but over time the tilt became more obvious and disfiguring....
    • Amy’s Story: A Battle With MS

      Amy's Story: A Battle With MSIn retrospect, multiple sclerosis had probably been stalking Amy for a long time. She had suffered from chronic headaches in high school, and her seasonal allergies had been over the top. Then, in her mid-30s, the busy wife and mother...
    • Brian’s Story: Meningioma

      Brian's Story: Meningioma “Carefree” is the word Brian uses to describe his life back then. He was 39 years old, happily married and the father of three children under the age of 5. “Life was busy, but that felt normal,” he says, reflecting. “The only...
    • Norma’s Story: Essential Tremor

      Norma's Story: Essential TremorQuestion: what progressive neurological condition causes a rhythmic trembling of the head, voice, legs or trunk; can be treated with medication or deep brain stimulation; has no definitive cure; and is eight times more common than Parkinson’s disease? If you’re...
    • Matt’s Story: Head Injury

      Matt's Story: Head Injury A poor decision nearly cost Matt his life. But state-of-the-art neurosurgical and neurocritical care, dedicated therapists, and family support gave him a chance to start over again. Today, in what is proving to his best decision ever, Matt is studying...
    • Amber’s Story: Ruptured Aneurysm

      Amber's Story: Ruptured Aneurysm The only visible sign of Amber Gray’s ordeal is the long slender scar that runs along her forearm. It is the area where a surgeon carefully removed her radial artery, which was needed to bypass a damaged artery in her...
    • Rick’s Story: Epilepsy

      Rick's Story: Epilepsy Rick’s strategy for managing his epilepsy wasn’t perfect, but it had worked well enough for most of his career as a theme park project manager who traveled the world. Whether he worked in Australia, Malaysia, Singapore or Germany, his routine...