Advances in stroke detection and treatment

A still relatively unknown diagnostic procedure available at Lakes Region General Hospital may help identify persons most at risk for one of the more common types of stroke.

Known as a carotid ultrasound, the test detects fatty plaque buildup in the carotid arteries on both sides of the neck. When blood flow to the brain is blocked, a stroke occurs and brain tissue is damaged.

It is estimated that carotid strokes are responsible for one-third or more of all strokes, said Dr. Glenn Fusonie, a vascular surgeon and member of Lakes Region Vascular and Endovascular Surgery, a department within LRGH.

"The carotid artery ultrasound looks at the images of the artery and the blood flow through the artery and that gives us information about whether that artery is diseased or not," Fusonie explained. "This is a non-invasive test that is very reliable in determining if there are significant narrowings in the artery."

Carotid ultrasound testing "has been around for some time," he added, but only now is it becoming "universally accepted" as a screening mechanism.

Along with old and new surgical procedures, the carotid ultrasound is increasingly helping doctors prevent strokes in some patients, while post-stroke therapies are helping put victims back on their feet, literally, as soon as possible.

The American Heart Association says that stroke is the leading cause of disability in the U.S. and the third most common cause of death behind heart attacks and cancer.

To prevent a stroke, the AHA recommends that people exercise regularly, control their blood pressure, not smoke, and cut down on foods that are high in cholesterol, fat, and sugar.

But when prevention alone is not enough, early detection and intervention are key, and for those persons who do suffer strokes, LRGH, as well as many other medical centers in New Hampshire, offer a variety of rehabilitative therapies.

Each person's stroke is different and the resulting complications are similarly different, said Stephen Fusco, an occupational therapist and director for rehabilitation at LRGHealthcare, the corporate parent of both LRGH and Franklin Regional Hospital.

Although therapies vary in treating stroke victims, the goal, he said, is the same: to get people up and moving and, in that way, back to health more quickly.

At LRGHealthcare, said Fusco, "we do an aquatic therapy program with our patients" to facilitate movement in a safe, controlled environment in which the patient can exercise more vigorously because the person's weight is offset by the buoyancy of the water.

That same philosophy takes a different form at Healthsouth Rehabilitation Hospital in Concord, according to Wendy Guillette, the stroke program manager there.

Utilizing an "unweighing device" - a harness that features a pressurized weight-control system - a therapist can gradually "unload" up to 150 pounds of a patient's weight and then gradually reintroduce it as the patient's strength and motor control improve.