Stroke Clinic

Stroke Team 2014

  • The University of Iowa Comprehensive Stroke Center (CSC) specializes in the treatment of patients who have suffered a stroke or have a cerebrovascular disease. 
  • Our Stroke Center is recognized as a leader in the treatment and prevention of stroke. 
  • We focus on compassion, convenience, and comfort for the patient while delivering advanced treatments (including the Neurointerventional Surgery Clinic).

History and Accomplishments

  • The UI Comprehensive Stroke Center (CSC) is a leader in both developing and conducting trials that test promising therapies for the prevention, treatment, and recovery of stroke.
  • Researchers at the CSC have been at the forefront of translational and clinical research in cerebrovascular disease since the Cooperative Aneurysm study in the 1960s.
  • The first dedicated stroke unit in the country was developed at our institution in the 1970s.
  • In the 1980s our institution held Master Agreements in Stroke with NINDS.  
  • As part of this program, we have designed and directed Phase I, Phase II, and Phase III trials testing promising treatments for acute ischemic stroke and subarachnoid hemorrhage.  
  • An important accomplishment was the creation of the National Institutes of Health Stroke Scale (NIHSS), which was developed and tested by the NIH and investigators in Cincinnati and Iowa City.
    • It is now the standard clinical assessment tool for determining the severity of neurological impairments with stroke and part of many clinical trials.  
  • Another accomplishment was the TOAST study (Trial of Org 10172 in Acute Stroke Treatment).  
    • TOAST was the first modern, Phase III trial of acute stroke treatment funded by an NINDS grant, which demonstrated the lack of effectiveness of anticoagulation in patients with acute ischemic stroke.  
    • The study also resulted in the creation of the TOAST classification of stroke subtype, which remains the primary system in use to categorize stroke mechanisms in trials, as well as in practice nationally and internationally.

Stroke quality measures at University of Iowa Hospitals and Clinics.

​Comprehensive Stroke Center Designation

Comprehensive Stroke Center logo

The Stroke Center at University of Iowa Hospitals and Clinics recently achieved Advanced Certification Comprehensive Stroke Center by The Joint Commission and the American Heart Association/American Stroke Association.

Comprehensive Stroke Center certification is given when centers meet the following criteria:

  • Coordinate post-hospital care for patients
  • Have dedicated and staffed neuro-intensive care unit beds for complex stroke patients 24 hours a day, seven days a week
  • Meet minimum requirements for providing care to patients with a stroke diagnosis
  • Participate in stroke research
  • Use advanced imaging capabilities
  • Use a peer review process to evaluate and monitor the care provided to patients with ischemic stroke and subarachnoid hemorrhage

Gold Plus Award Target: Stroke Elite Plus

For the second year running, the Stroke Center at UI Hospitals and Clinics has received the highest award available from the American Heart Assocation (AHA) and American Stroke Association (ASA). Learn more about the Gold Plus Achivement Award with Target: Stroke Honor Roll Elite Plus.

NIH StrokeNet Initiative

nih logo

The Stroke Center is also part of the National Institutes of Health StrokeNet initiative.  We are the regional coordinating center, and more information can be found at the UIRCC site.  StrokeNet is intended to streamline stroke research by centralizing approval and review, lessening time and costs of clinical trials, and assembling a comprehensive data sharing system.

What is stroke?

  • Stroke occurs when blood flow to the brain is interrupted, causing brain cells in the immediate area to die because they stop getting oxygen.
  • Stroke can also occur when a vessel breaks and bleeds into the brain.  
  • One way to remember if you or someone you are with is having a stroke, is to “Think BEFAST.”  

BEFAST is two things, really.

1. It’s what you do when you spot the signs of a stroke: BE FAST in getting the victim to emergency medical care.

2. It holds the key to recognizing someone may be having a stroke. Just remember these BEFAST words:

  • Balance
  • Eyes
  • Face
  • Arms
  • Speech
  • Time, not a symptom but a reminder to get medical help quickly

The BEFAST symptoms

You may not see all the symptoms at the time of a stroke. The key to noticing something’s amiss is the sudden onset of symptoms like these:

Balance – Sudden loss of balance
A stroke is caused by blood not flowing to portions of the brain. As parts of the brain shut down, muscle control and other senses are affected. Loss of balance could vary from that head-spinning feeling of just stepping off a merry-go-round to having one leg kicked out from a three-legged stool. Depending on when you encounter someone having a brain attack, they may be in the stage of feeling dizzy, grabbing at the air for something to steady themselves, or already crumpled in a heap.
Eyes – Sudden loss of vision in one or both eyes
While other diseases and injuries can cause a loss of vision, the key in a stroke is a sudden onset with no previous symptoms. Vision loss is a matter of degrees, your victim may not have total loss of vision but may be having blurred vision or double vision as a result of the brain attack.
Face – Looks uneven
A stroke may affect the nerves that control facial expressions. Frequently only one side of the face is affected and the result is an uneven look—a drooping of the eyes, mouth, and cheeks.
Arms – One arm is weak or numb
The same droopiness that affects the face can affect an arm or leg. It’s just a different set of nerves being affected by the brain attack. The arm weakness may be a matter of degree, ranging from numbness to flat out being unable to move or function.
Speech – Slurred or seeming confused
When the brain’s speech center is under attack the results are going to be confusion, problems enunciating words, incomplete thoughts, or bizarre and random associations. Other diseases or injuries can cause similar patterns, but the key to a brain attack is a sudden onset of these symptoms.
Time – Call 9-1-1 now
Brain attacks happen with all degrees of severity and there’s rarely a gold-standard where all the symptoms are in play and easily recognized. If you’re seeing any of the BEFAST signs with that underlying theme of suddenness, make the call.

What happens after a stroke

  1. ER: Triage, diagnosis/tests, medication for acute effects, monitoring
  2. ICU: Recovery, monitoring and tests
  3. Neurology Clinic: Ongoing treatment and followup
  • MAGIC
    • Provides support and education to individuals with aphasia and their family members.
  • Stroke Camp
    • Camp aimed at helping survivors and caregivers improve their quality of life.

Referring Physicians and Telemedicine 

The Stroke Center offers referring physicians a 24/7 consultation with a stroke physician and our nurse coordinator facilitates transfer of patients to our care. 

The center also utilizes telemedicine to provide remote consultation to stroke patients in other parts of the state or country.  

Education of Medical Students

The Stroke Center helps train fellows in our ACGME approved vascular fellowship program. Visit Vascular Neurology Fellowship for more information.

Clinical Trials

Below are the clinical trials the Stroke Center is currently conducting.  Click on the associated link(s) to get more information and/or apply.

  • CLEAR III Trial: Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III
  • IDEF: Intracerebral Hemorrhage Deferoxamine Trial
  • MR WITNESS: A Study of Intravenous Thrombolysis With Alteplase in MRI-Selected Patients
  • POINT Trial: Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial
  • SHINE: Stroke Hyperglycemia Insulin Network Effort Trial

For more information, please see our About Your Neurology Visit guide.

If you are interested in finding out more about the Department of Neurology, our research and educational programs, news and events, or how you can give by donating, please visit our academic and departmental website.

Care Team

Nurses

  • Heena Olalde, RN
  • Erin Rindels, RN
  • Jeri Sieren, RN
  • Angela Overton, RN