UAMS Stroke Care Ensures Patient Can Tell His Story

By Ben Boulden

UAMS recently became the first and only health care provider in Arkansas to be certified as a Comprehensive Stroke Center by The Joint Commission, which accredits nearly 21,000 health care organizations and programs in the United States for meeting certain performance standards.

Radvany checks Morrison's vision.

Radvany checks Morrison’s vision.

Luckily for Morrison, when he had his stroke in March, the efforts to achieve certification were well under way.

“As a comprehensive stroke center, we have the ability to take care of patients not only with stroke but all cerebrovascular disease, 24/7,” said Martin Radvany, M.D. “We have the intensive care, neurosurgical, neurology, and radiology teams in place to provide this care. UAMS Medical Center is the only hospital in the state that has the comprehensive stroke center designation. This is the best place for cerebrovascular care.”

Radvany is a professor and chief of Interventional Neuroradiology in the UAMS College of Medicine Department of Radiology. He treated Morrison at the medical center when he arrived March 14.

The start of that day was relatively ordinary for Morrison. He said nothing was unusual about it until he got to his workplace, a heating-ventilation-and-air conditioning company in Hot Springs where he works in sales and service. He spoke to a coworker who was walking by the doorway of his office. When Morrison verbally greeted him, the words and sounds he spoke didn’t make sense. He started experiencing paralysis on one side of his body and when his coworker stopped to see what was wrong, he managed to get out the word, “Hospital.”

After being taken to a Hot Springs hospital, Morrison and a stroke team there consulted via a live video connection on the AR SAVES network with Krishna Nalleballe, M.D., at UAMS. At Nalleballe’s direction, alteplase, a powerful clot-busting drug, was administered to Morrison. The tele-stroke network, the Arkansas Stroke Assistance through Virtual Emergency Support (AR SAVES), uses a high-speed video communications system to help provide immediate, life-saving treatments to stroke patients 24 hours a day.

Morrison next was transported by a helicopter air ambulance to UAMS Medical Center. When the care team landed with him, they brought him in through the Emergency Department, and it was clear on the CT images that the carotid artery in his neck was blocked along with other blood vessels in his brain. A large portion of the brain also was at risk for further stroke unless fast action was taken.

Radvany helped lead the effort to achieve Comprehensive Stroke Center designation from The Joint Commission.

Radvany helped lead the effort to achieve Comprehensive Stroke Center designation from The Joint Commission.

“His stroke was caused by a tear in the carotid artery, which was unusual, but we do see this a few times a year,” Radvany said. “The notable thing about his case is how young he is, 43. It was really important that they got him here in a timely manner to treat him. He had none of the risk factors we see in older patients like high blood pressure, diabetes or smoking. There was no known trauma or event that caused the tear.”

Radvany performed a thrombectomy, a surgical procedure used to extract the clots from Morrison’s blood vessels. The procedure was successful, and shortly after, he was able to move his foot again. Morrison recovered most of his motor functions within 24 hours, but he still had trouble finding words and some weakness. However, by the time of his first speech therapy appointment, even his ability to speak was normal. The therapist assessed his vocal ability and told him he needed no additional visits.

“I came in on a Wednesday, and I was able to get up and go home on Friday,” Morrison said. “I went back to work a little more than a week later. It was the response that impressed me, how quickly everyone responded to me. The care they gave me. This situation couldn’t have turned out any better for me. When you’re having a stroke, time is essential, and the quicker you can get treatment the better the outcome.”

Only 3 percent of hospitals achieve comprehensive stroke center designation that UAMS recently earned, Radvany said.

“I believe I got the best medical care that could have been provided for me,” Morrison said. “Dr. Radvany was great. I couldn’t have gotten any better care anywhere else. I’m grateful that the ER doctor in Hot Springs got me to where I needed to be. That’s right here at UAMS.”