Stanford Stroke Center Recognized for Excellence

By Pam Lowney

Pursuing both research and patient care, the Stanford Stroke Center has long been a leader in understanding and treating cerebrovascular diseases. Established in 1992, it was one of the first facilities of its kind to adopt a multidisciplinary approach to stroke care, bringing together neurologists, neurosurgeons and radiologists. Garnering more than $35 million in NIH funding, its research efforts have resulted in more than 100 clinical trials and more than 500 published papers.

This August, the Stanford Stroke Center was nationally recognized for excellence by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the nation's predominant accrediting body in health care, which designated the Stanford Stroke Center as a primary stroke center. Stroke, which occurs when a blood vessel carrying oxygen to the brain suddenly bursts or becomes blocked, is the leading cause of adult disability and the third leading cause of death in the United States .

By recognizing select medical facilities for their advanced stroke care, the JCAHO designation helps the public identify which hospitals offer the best possible outcomes for stroke patients. Stanford is the 15th hospital and the second academic hospital in the country to be stroke certified.

The stroke center received its accreditation after demonstrating compliance with a strict standard of care. Its ability to effectively administer tPA, the only drug approved by the FDA to dissolve blood clots in the brain, was a key factor in this process.

"About 85 percent of strokes are due to a blood clot blocking a blood vessel to the brain,” says Gregory Albers, MD, professor of neurology and neurological sciences and director of the Stanford Stroke Center . “If we give tPA within a few hours of stroke onset, we can often dissolve the clot and restore the blood flow. If things go well, the patient has minimal or no neurological damage from the stroke.”

Though FDA-approved since 1996 and generally recognized for its efficacy, tPA today remains widely unavailable. “Most hospitals have still not set up stroke treatment teams and appropriate protocols to insure rapid administration of tPA to eligible patients” says Albers.

Until JCAHO launched its certification program in November 2003, it was a matter of luck if a person ended up at a hospital that provided tPA. By clearly delineating differences among hospitals, it is expected that the program will influence where EMS providers transport patients with stroke symptoms.

In addition to its work with tPA, the Stanford Stroke Center is one of the few facilities in the country with more than a dozen state-of-the-art diagnostic devices for the rapid and precise assessment of a patient’s condition. It is pioneering the use of new preventive medications, and it is developing new techniques for the treatment of stroke, including advanced surgical and neuroradiology procedures, hypothermia and other neuroprotective strategies.