Our clinical services
At Barts and The London Brain Attack Centre, we are committed to offering individualised and rapid care for the treatment of strokes.
Our acute stroke patients go straight from The Royal London’s A&E to our specialist stroke unit on Gloucester ward at the hospital rather than via medical admissions. This means we provide rapid access to a CT scan to determine the cause of the stroke and then appropriate treatment will be given after medical assessment. We are currently planning a pilot of thrombolysis treatment (clot-busting drugs) in selected patients.
Once on the unit, patients are also closely monitored with specialist equipment during the first 42 hours. Immediate nursing care is on hand to prevent further complications, and at the same time we can treat patients with drugs and rehabilitation including physiotherapy, occupational therapy and speech therapy from day one.
Please click on the headings on the left to find out more about our services:
Hospital tests
Thrombolysis (clot-busting drugs)
Drug treatments
Clinical Assessment
Rehabilitation
Lifestyle advice
Mini strokes (TIA) clinic
These tests are necessary to find out where the stroke is, how serious it is and what caused it (a bleed into the brain or a blood clot). It is important to have these tests as soon as possible after a stroke to ensure a better chance of recovery.
At Barts and The London Brain Attack Centre, we offer all the specialist investigations, whether the person is seen as an outpatient or has come from our A&E department.
A CT scan of the brain is carried out as soon as possible and the patient may also have blood tests, a blood pressure test, and an ECG (electrocardiogram) which tests for unusual heart rhythms as this can be a risk factor for stroke.
Thrombolysis (clot-busting drugs)
The latest treatment for some forms of stroke (those caused by a clot) is thrombolysis using a drug called alteplase, given by intravenous infusion (directly into the bloodstream). This dissolves the clot and restores the blood supply to the affected part of the brain. If there are nerve cells in this area that are still viable there is potential for these cells to recover if the treatment is given in time – within just three hours of the stroke happening.
The treatment can cause bleeding into the brain, especially if the stroke is a large one and it does not always work so only a few patients are suitable and specialist care is needed to ensure the treatment is as safe as possible.
On the positive side, in centres where this treatment is used, patients who are suitable stand a reasonable chance (1 in 8 to 1 in 3) of complete recovery, whereas otherwise they would have suffered a disability.
We are introducing a pilot thrombolysis service for a few carefully selected patients over the winter of 2007/08.
Most stroke patients need a combination of drugs to reduce the clotting tendency of the blood, blood-pressure lowering treatment and drugs to reduce cholesterol.
Once a stroke has been diagnosed, it is important to determine how it will affect the patient. An expert therapy team including a physiotherapist, an occupational therapist and speech therapist is on hand within the acute hospital and rehabilitation unit to provide full assessment of a person’s physical, sensory, cognitive, perceptual, speech and swallowing difficulties after a stroke and suggest the most appropriate rehabilitation.
Our stroke team works out an individual rehabilitation programme for each person who is being treated for stroke. This can include help at home and in the community from a physiotherapist to help with muscle weakness, a speech and language therapist to help with swallowing and communication problems, a clinical psychologist to help with emotional problems, and an occupational therapist to help the patient with doing everyday tasks such as dressing and washing themselves.
There is much we can do nowadays to reduce the risk of another stroke. Our specialists can give advice on lifestyle changes such as giving up smoking, having a healthier diet and taking more exercise if possible.
A transient ischaemic attack (TIA) happens due to a temporary lack of blood to part of the brain and causes a set of short term symptoms. It is sometimes called a ‘mini stroke’ but unlike a stroke, the symptoms do not last and patients recover within a few hours.
However, there is a 10% risk of having a large stroke in the week following a TIA.
Barts and The London Brain Attack Centre introduced a new procedure in June 2007 which enables these patients to be diagnosed at our TIA clinic, based at Mile End Hospital, and have accelerated treatment. These patients can now be seen urgently when referred by their GP or The Royal London’s A&E department. It is thought this will help around 100 people a year who suffer from TIAs.
