The UCSD Stroke Team is available 24 hours per day, 7 days per week at the two UCSD Stroke Center locations: UCSD Medical Center in Hillcrest and the Perlman Ambulatory Care Center in La Jolla.
When a potential stroke patient arrives in the Emergency Room, the Stroke Team performs an immediate physical exam and neurologic screening. By doing this, we can identify patients who are suffering from a peripheral nerve lesion, migraine, or other disorder that mimics the symptoms of stroke.
- See an illustration of a stroke
If stroke is suspected, the Stroke Team has immediate access to the latest diagnostic technology to evaluate the type and extent of stroke and determine the most effective treatment. Our technology includes:
- CT (Computed Tomography)
- MRI (Magnetic Resonance Imaging)
- CT and MR angiography
- Contrast-enhanced ultrasound, which can determine whether the patient is a candidate for tPA (a clot-dissolving medication)
- Diffusion and perfusion imaging that can identify the areas of damaged brain tissue
- Transcranial doppler (TCD) that measures the velocity of blood flow and assists in stroke evaluation
Treatment Options
We will determine the best treatment for each individual, depending on the type of stroke (ischemic or hemorrhagic), the time that has elapsed since symptoms began, the precise location of the clot, and what type of damage has occurred.
Medication: The most common stroke treatment is the medication known as tissue plasminogen activator (tPA), a thrombolytic agent commonly called a “clot-busting drug.”
- This drug, which can dissolve blood clots, can be used in all ischemic stroke patients within three hours and in selected individuals within four and one half hours.
- This drug is used in the treatment of ischemic stroke and can significantly reduce the effects of stroke and reduce permanent disability.
During the 1990s, the UCSD Stroke Center led the National Institutes of Health-sponsored clinical trials of tPA therapy for stroke. The drug subsequently received FDA approval for treatment of ischemic stroke.
- Since tPA must be given within the first few hours after symptoms begin, it is vital that you seek treatment immediately if you think you are having a stroke. Call 911 immediately if you have signs or symptoms of a stroke.
Endovascular procedures: UCSD is a leader in the field of endovascular intervention for stroke, using specially-designed instruments to remove blood clots and restore blood flow to the brain.
During an endovascular procedure, a catheter is passed through a groin artery and guided to the brain artery that is blocked. Then, the removal instrument is advanced through the catheter to the clot to open the blood vessel and remove the clot.
- Like tPA, endovascular intervention should be used within the first hours of a stroke. In contrast to tPA that is currently only used within 4.5 hours after stroke onset, the endovascular procedures raise hope that the time window may be extended, but even so, sooner therapy is more effective than later.
Two of the devices currently being used at UCSD are the Merci Retriever – the first medical device cleared by the FDA to remove blood clots from the brain in patients experiencing an ischemic stroke – and the Penumbra System, a device that dissolves the clot and suctions it out.
Both the Merci and Penumbra can be used to reopen one of the larger blood vessels inside the brain when an acute stroke is affecting brain blood flow.
Clinical trials
UCSD’s Stroke Center is also conducting a number of clinical trials using promising new treatment therapies such as hypothermia (cooling the brain to extend the window of treatment), medications and neuro endovascular therapy (including the Merci Retriever).