We offer comprehensive adult stroke care that begins the moment a patient is seen emergently with a new stroke, stretches through the initial hospitalization and continues as a patient is discharged and starts rehabilitation.
The two components of our adult stroke care are the in-patient wards where a patient is under the care of our dedicated stroke team and the out-patient clinics where stroke survivors are seen for ongoing consultation.
Our inpatient team is a dedicated team responsible for helping a patient in the first few days after a stroke has occurred. This is a critical time in a stroke survivor’s journey. We lay the groundwork to help understand why a stroke has occurred, offering the most current, evidence-based treatments to minimize the chance of further strokes. At the same time, we begin assessments for rehabilitation needs and discharge planning with plans individualized to fit each patient’s specific needs.
Some stroke patients may require initial admission to our neurological ICU. In such cases, we work together with our neurointensivist colleagues until the patient is ready to be transferred to the care of our adult stroke team.
Ongoing evaluation and care of a stroke occurs in our Comprehensive Adult Stroke Clinic where we offer continued assessments and care plans for stroke survivors. Many strokes are due to well-known traditional stroke risk factors such as high blood pressure, high cholesterol, diabetes, smoking, obstructive sleep apnea, heart disease and others. Controlling these risk factors is critical to help minimize the chance of future strokes.
Our specialists, also, offer subspecialty clinics related to more rare causes of stroke. This includes stroke due to issues such as the following:
- Carotid or vertebral dissections
- Genetic causes of stroke such as sickle-cell disease, Fabry disease and others
- Moyamoya disease
- Fibromuscular dysplasia
- Arteriovenous and other intracranial vascular malformations
- Antiphospholipid antibody syndrome
- Inflammatory blood vessel disorders such as temporal arteritis and cerebral vasculitis (infectious, toxic and others)
- Cancer-associated stroke
- Venous disorders such as cerebral venous sinus thrombosis
Many of these causes of stroke require a treatment team, and in such cases, we are experienced in working with our colleagues to offer the best treatment plan according to each patient’s individual needs and goals for their own care. Treatment teams may include our colleagues from neurosurgery, neurointerventional radiology, medicine, cardiology, hematology, oncology, vascular surgery, obstetrics, gynecology and others.
The hyperacute stroke treatment team (HASTE) is a dedicated core of physicians run by one of our stroke specialists. We respond to emergent internal consultations at Barnes-Jewish Hospital. We help perform emergent and accurate history and physical examinations of acute stroke patients. This allows us to make an informed diagnosis and when appropriate, offer the most current, evidence-based treatments for acute stroke care to help minimize a patient’s long-term morbidity and even mortality.
Stroke can happen at any time without warning. Our HASTE team primarily responds to consultations in the BJH emergency department. We are also ready to respond at a moment’s notice to an emergent call for help anywhere in the hospital.
Where the HASTE team is the internal branch of our acute stroke care at BJH, please see the telestroke clinical services for more information related to our selestroke program — the external branch of our emergent stroke evaluation and care team.
Telestroke is an ever-growing service we offer. Our telestroke program goes hand-in-hand with our HASTE team, acting as the external branch of our ability to perform consultations for stroke in the emergent setting.
In cases of acute stroke, patients are necessarily directed to their closest emergency department. In many of these cases, the treating emergency physician will then contact us to help guide the emergent evaluation and care of these stroke patients. We are even able to join a HIPAA-compliant, Zoom-like video call to speak with and examine the patient when needed.
As always, time is brain in acute stroke care. Through our telestroke program, we are able to help our many physician colleagues with faster, more accurate diagnosis and treatment of stroke. We are proud to extend the same level of care and attention to detail offered to patients who initially presented to Barnes-Jewish Hospital.
We contract with multiple hospitals in the St. Louis metro area, greater Missouri and Southwestern Illinois.
If you’re interested in learning more about joining the WashU telestroke network, contact Jill Newgent at newgentj@wustl.edu.
Strokes can leave a patient with difficulties in their vision, speech, memory, movement and balance. Issues such as weakness on one side of the body may persist, requiring patients to relearn how to perform some basic functions and activities of everyday living. Ongoing rehabilitation is one of the cornerstones of recovery following a stroke. It aims to help restore or compensate for these difficulties. As a Comprehensive Stroke Center, we work closely with colleagues in neurorehabilitation to aid our patients in their recovery journeys following a stroke.
Evaluation for each patient’s neurorehabilitation needs starts at the very beginning of their hospitalization. In fact, we employ a multidisciplinary team that includes providers from stroke neurology, physiatry, physical therapy, occupational therapy, speech therapy and social work to help identify the best course of rehabilitation for each patient. The result is an individualized rehabilitation plan that continues with a patient even after their discharge from the hospital and return home.
