Stanford Health Care-ValleyCare Hospital in Pleasanton has been certified as a primary stroke treatment center.

The designation makes it possible for stroke victims in the Livermore-Pleasanton-Dublin area to be treated locally and quickly with top quality medical care.

Until now, residents and visitors experiencing stroke had to be transported to distant centers for the needed medical care.

Primary stroke center certification came last week from an organization called the Joint Commission, which evaluates healthcare institutions and programs nationwide with the goal of assuring consistent, high standards.

The Joint Commission carries out these evaluations in a wide range of medical fields which includes neurology, the discipline in which stroke medicine generally falls.

Its evaluators carried out on-site assessments of the local hospital’s stroke care program in August.

They measured hospital performance against more than 100 standards for the care of stroke patients. In many cases, these standards include time as a criterion, since successful stroke treatment depends heavily on fast response.

Evaluations included such crucial issues as how long it took for patients with stroke symptoms to receive a tomographic brain scan; how quickly stroke victims received a clot-dissolving medication called tPA; and the quality of care administered within those time frames.

Rick Shumway, President and CEO of Stanford Health Care-ValleyCare, said the organization is “proud to receive this certification…(which) allows us to provide some of the very highest levels of neurovascular care available in the region to the many stroke patients that need it most, at the most critical times.”

Speed is Vital

For years, stroke was the third leading cause of death in the U.S., but advances in diagnosis and treatment have improved outcomes and lowered its ranking to the fifth leading cause of death, according to the Centers for Disease Control.

Americans experience nearly 800,000 strokes per year, some 140,000 of them fatal.

Successful treatment depends heavily on speed.

Only about one-fifth of stroke victims reach appropriate care fast enough that doctors can expect to prevent or reduce serious complications, according to Dr. Prasanth Krishnomohan, medical director of neurology at Stanford-ValleyCare.

Until now, someone in the Livermore-Pleasanton area who suffered a possible stroke might be rushed by ambulance to a distant stroke treatment center, perhaps in Walnut Creek or Fremont.

Informal anecdotes from emergency response crews suggested that a potential stroke patient was being transported out of the Tri-Valley every day or two, costing precious time before full treatment could start.

Sometimes well-meaning friends and family members would drive stroke victims to Stanford-ValleyCare, only to have emergency room physicians send them via ambulance to a distant stroke center.

Given the new certification of Stanford-ValleyCare, emergency crews that once raced past will be able to bring the patients to Pleasanton for local diagnosis, faster treatment and improved chances of a healthy outcome.

Blood Flow Blocked

Most strokes occur when blood flow in the brain is blocked, often by a clot broken loose from some other part of the body. These so-called ischemic strokes represent upwards of 85% of all strokes.

Not many years ago, the most common treatment for stroke was no treatment – wait and see how the patient recovered. In 1996, the federal Food and Drug Administration approved the use of tPA, a drug that helps break up clots.

TPA, commonly called alteplase, stands for tissue plasminogen activator. It works by stimulating the production of plasmin, an enzyme that helps dissolve blood clots.

The less common type of stroke is hemorrhagic, caused by a burst blood vessel in the brain.

Whichever type of stroke occurs, rapid treatment is crucial, since without blood, brain tissue begins to die fast. According to the American Heart Association and American Stroke Association, 10% of brain function may be lost every 30 minutes without adequate blood supply.

It’s vital to know which kind of stroke to treat, since tPA administered to break up a clot could make a hemorrhagic stroke worse. Hemorrhagic stroke may be treated by inserting a tiny mechanical device, like a coil, to stop further rupture of the vessel, or by surgery.

In the years after tPA was introduced for ischemic strokes, it was found that the drug was mainly effective if administered within three hours. It could also help a smaller number of patients if given after three hours, and up to 4.5 hours, following a stroke.

Advances in telemedicine, including high definition video and software that makes medical records available while ensuring patient privacy, have also led to major strides in stroke care.

Neurologists who specialize in stroke need not be present at every hospital, but can diagnose and treat stroke victims from a distance, provided appropriate cameras and treatment facilities are in place.

Krishnomohan, expects most stroke patients at the Pleasanton facility to be treated by resident neurologists, but if they are unavailable, specialists at Stanford’s main Palo Alto center provide 24/7 medical backup.

Stanford-ValleyCare will be able to treat the great majority of stroke patients, he said. Perhaps 10% will be sent to Palo Alto for specialized care, such as neurosurgery or a thrombectomy, in which doctors thread a catheter into the brain to remove a clot.

ValleyCare Charitable Foundation

In addition to validating the quality of the Stanford-ValleyCare stroke program, the certification also reflects the success of the Campaign for Stroke Care, a fund-raising effort launched last year by the ValleyCare Charitable Foundation.

Shaké Sulikyan, Executive Director of the Foundation, thanked the community for its “unprecedented contributions… We know that timely access to acute stroke care can be the difference between a full recovery, a lifetime of disability, or death.

“We are thrilled to put in place the necessary components to provide acute care to patients in the Tri-Valley,” she said.

Krishnomohan echoed her enthusiasm. “We are really excited to bring this service to the community,” he said. “It has been a lot of work from a lot of people. We want to really thank everyone in the community who has supported this program.”

The Foundation will continue its fund-raising, Sulikyan said. She invited the community “to join us in celebrating this amazing milestone by donating to the Campaign for Stroke Care and helping to raise the final $340,000 and cross the Campaign finish line.”

Sulikyan expressed particular gratitude to Lynn and Joan Seppala, owners of the Independent, who contributed major funding to the Foundation. Lynn Seppala suffered a major stroke at age 46.

Adding to Sulikyan’s call for continued community donations, the Seppalas issued a joint statement of their own: “Let’s make sure that Stanford Health Care-ValleyCare can offer the best possible care for our friends and neighbors, sparing them from much of the damage and trauma that we experienced 27 years ago when Lynn experienced his stroke.”