The importance of identifying stroke as a medical emergency has been underrated in the past, partly because it was assumed that not much could be done for stroke patients. Today, the picture is changing. There is increased awareness of the dangers of stroke, and of the possibility of reducing the damage by taking quick, effective action. The brain is thought to be mysterious and difficult to understand. The reality is that neurological emergencies are no more difficult to handle than any other emergencies, although the question of follow-up may be more complex.
What Happens in the Emergency Department?
When you go to the emergency department, the first person you meet may be a triage nurse who decides how serious the problem is. An emergency doctor will then assess your condition. Next, a neurologist, internist or family physician will be called to take over the continuing care. In smaller hospitals, family physicians may assess their own patients in the emergency department and look after them thereafter.
There are three steps in the assessment of a patient: the medical history, the examination and diagnostic tests.
What’s a Neurologist?
Neurology is the study of diseases of the nervous system. The nervous system consists of the brain, the spinal cord, the nerves and the muscles. A neurologist is a medical specialist who mainly treats diseases of the nervous system that respond to medications. Neurosurgeons mainly treat diseases of the nervous system that can be corrected with surgery.
Assessing the Patient
The first step is getting your medical history. The doctor will ask for a description of your symptoms and how they first appeared. This is the most important stage of the assessment. You should also provide as much information as possible about earlier warning symptoms, your family history, problems in other parts of your body, medications you take, and your present state and any worries you have. The second step in diagnosis is the physical examination. Your doctor may discover factors that are contributing to your symptoms, such as an irregular heartbeat, as well as assessing the severity and type of stroke symptoms you are experiencing, such as weakness on one side.
Testing the Brain
The third step in diagnosis is testing. Doctors will examine images of your brain, looking for several things. First, they need to determine if there is blood in the brain and, if so, where. They will look for early evidence of dead tissue in the part of the brain that has been deprived of blood. (In some cases the evidence of dead brain tissue will not show up for hours.) Finally, they will check for other possible causes of your symptoms-conditions that can mimic stroke, such as a growing brain tumor. Two methods are used to obtain an image of the brain: computerized tomography scan and magnetic resonance imaging.
Computerized Tomography (CT) Scan
In this test, X-rays are beamed in such a way as to reveal the structure of the brain. Your head is placed in a device that looks like a big salon hair dryer. It’s a painless procedure; all you have to do is lie back and relax while a picture is taken.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging uses radio frequencies to displace water molecules slightly, after a portion of them have been aligned in a strong magnetic field. As the molecules regain their original positions they give off magnetic energy in the brain, which is captured in an image. With the MRI it is also possible to make pictures of the blood vessels in the head and neck. This process does not use any radiation. MRI technology is advancing at a tremendous rate, and yielding more and more information. In places where it’s available, it’s becoming the imaging method of choice.
Gay Threadgill is a medical representative working for a large pharmaceutical in Boston. He draws his inspiration in medical tourism through Satori World Medical. Follow him @GayThreadgill1