Stroke risk management and preventionCall for an appointment
As a Comprehensive Stroke Center, Duke offers the highest level of specialized stroke prevention and stroke care. If you have been diagnosed with conditions that increase your risk of stroke, we work closely with you to prevent stroke from occurring. If you experience a warning stroke - known as a transient ischemic attack (TIA) - we see you immediately to reduce the likelihood a major stroke will follow. If you have a stroke, our experts provide the highest level of care from the second you arrive in the emergency room through your stroke recovery. We are trained in the latest procedures and technology, ensuring you receive a rapid response and coordinated care for your stroke recovery.
Immediate care for TIA
If you experience a warning stroke, or TIA - transient ischemic attack - your risk of having an actual stroke increases dramatically. You need immediate care. Symptoms of a warning stroke include the following sudden changes:
- Numbness or weakness of the face, arm or leg, especially on one side of the body
- Confusion, trouble speaking or understanding
- Trouble seeing in one or both eyes
- Trouble walking, dizziness loss of balance or coordination
If you experience these symptoms, seek emergency care immediately. If you experienced these symptoms in the past five days, we will see you within 24 hours. Please call our clinic triage nurse at 919-684-3573 for more information.
Every minute counts in stroke care
Every minute counts when you or a loved one suffer a stroke. Fast, effective treatment minimizes brain damage and complications. That’s why our Acute Stroke Response Team is available around the clock and is activated immediately when critical patients arrive at our hospitals. As a Comprehensive Stroke Center, we are among a select group of hospitals that meet the highest standard of stroke care in the U.S. Our stroke specialists treat the full spectrum of stroke including ischemic (clotting) stroke and hemorrhagic (bleeding) stroke. We understand your medical needs and constantly monitor your progress. We make sure you receive the rehabilitative or specialized therapy services you need to transition home. Our goal is to provide as much support as possible to assist you in your stroke recovery.
Choose Duke for your stroke prevention and stroke treatment because we offer:
- National leaders in stroke prevention and stroke care. We are part of a small group of the nation's elite hospitals certified as a Comprehensive Stroke Center. To receive this certification, we meet rigorous standards set by the American Heart Association/American Stroke Association, and The Joint Commission, the national organization that accredits hospitals. If you are at risk for a stroke, we work closely with you to prevent stroke. If you have a stroke, you are treated by our specialized stroke team which includes experts from multiple specialties who have undergone advanced training and use the latest technology to deliver the fastest, most comprehensive stroke treatments possible.
- Dedicated stroke team. Our stroke specialists are board-certified in vascular neurology, a subspecialty of neurology that involves stroke care and/or neurologic intensive care. Our neurological care team also includes specially trained nurses, physical and occupational therapists, speech and language pathologists, nutritionists, pharmacists, and technicians. All are trained to work with stroke patients.
- Award-winning services, excellent outcomes. Our neurological programs consistently rank among the best in the country by U.S. News & World Report. Our stroke team’s commitment to improving patient care and patient outcomes is recognized by the American Heart Association and American Stroke Association, which awarded us their Silver Plus Achievement Award and Target: Stroke Elite Honor Roll as part of their 2016 Get with the Guidelines-Stroke program.
- Carefully coordinated care. Your neurological care includes access to all of our specialists throughout your treatment and stroke recovery, including neuroradiologists, cardiologists, vascular surgeons, pharmacists, dieticians, and therapists, including physical, occupational, speech, and language experts.
- Breakthrough research. As a Comprehensive Stroke Center, we help set the national agenda for stroke prevention, stroke care, and stroke research. In fact, our team is helping to write the national guidelines for stroke prevention and treatment. Stroke specialists around the country look to us as leaders in research. Our work includes pioneering blood tests that enable doctors to accurately diagnose ischemic stroke more quickly, so treatment can begin sooner.
- Clinical trial access. We participate in studies and clinical trials that give you access to the latest treatments available. Ongoing trials include studies on the genetics of vascular disease, as well as new approaches to stroke prevention, stroke treatment, and ways to enhance post stroke recovery.
- Patient support. We sponsor a variety of stroke education and screening events, as well as support groups for patients and their loved ones. The Duke Stroke Support Group meets monthly, and public awareness events for stroke prevention take place throughout the year.
Thrombolytics -- drugs that dissolve clots to restore blood flow to your brain -- are the first line of treatment when ischemic stroke occurs.
Surgery may be needed to repair blood vessels damaged by a hemorrhagic stroke, or to open up arteries nearly blocked by plaque to prevent an ischemic stroke. Our experienced neurosurgeons and interventional radiologists use small incisions and X-ray images as a guide. The minimally invasive procedure involves the use of tiny instruments inserted into your blood vessels and arteries with a long, flexible tube called a catheter to repair the damage.
We work with you to identify the causes of your stroke, help your stroke recovery, and begin secondary-stroke prevention. We arrange rehabilitation and therapy services with our wide network of outpatient specialists and on an inpatient basis at the Duke Rehabilitation Institute.
This minimally invasive procedure uses a catheter to access the carotid artery. A balloon is inflated to open the artery and a small metal mesh tube, or stent, is inserted to maintain the opening. The artery heals around the stent.
Given before and after stroke to prevent clotting and narrowing of the arteries.
At Duke, you have access to medically supervised exercise programs, nutrition and weight loss counseling, and high blood pressure management to help you manage your risk factors for stroke. Our goal is to reduce your chances of having a stroke or heart attack and improve your overall health.
Because stroke can affect both communication and swallowing, our speech-language pathologists will work with you in the hospital to help with immediate communication and swallowing needs. Whether you have aphasia or other cognitive-communicative impairments, we will provide ways for you to communicate with your medical team and your family. We can also help you transition to life with changed communication after you go home. We assess your swallowing abilities in the hospital and provide ongoing therapy and recommendations to make eating and drinking safer and easier.
Our experts may use one or more of the following tests to diagnose whether you suffered an ischemic or hemorrhaging stroke, and to plan treatment:
Uses a scanner to take images of your brain and shows areas with any bleeding or other damage.
Uses powerful magnets to take highly detailed pictures of your brain that your doctor uses to assess damage to areas affected by stroke.
Determines if your blood is clotting properly, which is crucial information for your care. Can also be used to determine if blood levels are out of balance.
Ultrasound of your heart that can find any blood clots that may have caused a stroke.
Both CT and MRI can be used to show narrowing or other abnormalities in the blood vessels in the brain. If necessary, a catheter angiogram can be performed in which a doctor injects dye into the arteries leading to the brain to determine if blockages are present and the most appropriate treatment.