Pope’s stroke is ‘an opportunity to teach,’ expert says. ‘It’s another gift he’s given.’

The stroke-related death of Pope Francis is not only an occasion for reflecting on his life and legacy, says MUSC Health stroke expert Christine Holmstedt, D.O. “Let's use it as an opportunity to teach, if we can. So it's another gift he's given.”

A gift that could save lives. Every 40 seconds, somebody in this country has a stroke. And every three minutes, somebody in the United States dies from a stroke.

The Pope’s death comes about a week before the start of American Stroke Month, a time to focus on how people can try to prevent strokes, the signs someone is having a stroke and the importance of getting treatment as quickly as possible.

Stroke prevention

Holmstedt, a professor in the Department of Neurology at the Medical University of South Carolina, said prevention involves medical care and lifestyle choices.

 

“We recommend seeing a primary care physician for regular cardiovascular health screenings and blood pressure checks. If your blood pressure is consistently over 130 over 80, make sure you talk to your primary care doc about that.”

Holmstedt also recommended getting screened for diabetes and high cholesterol. “Primary prevention is key. We don't do enough of it. We just don't.”

Other prevention methods involve diet and movement. “Eating a healthy diet, low in salt, is important.” Holmstedt cited the Mediterranean diet as a good example of that. “It’s high in lean proteins, vegetables and fiber.”

On the movement front, Holmstedt said it’s important to be active when it comes to stroke prevention. “It doesn't mean you have to run a marathon. Just stay active, get up on your feet, walk 10, 20 minutes several times a day – just keep active.”

Finally, she said, smoking is highly associated with not only strokes but also heart attacks. “So avoid tobacco products.”

Warning signs of stroke

Holmstedt said people of all ages can have strokes, so it’s worth knowing what to watch for at any age. “If you witness someone experiencing facial drooping, arm weakness, leg weakness, acute confusion, difficulty getting their words out, slurring of their words or difficulty finding the right words or understanding what's being said to them, call 911.

 

"We recently had a child who had a stroke that just got airlifted in. It's not common in people that age, but it happens. And so everyone needs to be aware of it.” That said, aging does increase the odds of having a stroke.

“The risk factors for stroke go up as we age. And the Pope had some of those risk factors, including high blood pressure and diabetes.” The Pope had also suffered from a recent bout of pneumonia.

Stroke treatment

Timing is everything when it comes to treatment after a stroke. “Once stroke symptoms are recognized, call 911. The faster you get to the Emergency Department, the faster you get treated, the more likely you are to make a complete recovery.”

She’s trying to raise awareness about the fact that there are effective treatments. “We're still teaching the general population about this. The treatments are 20 years old. They are very effective.”

At the MUSC Health Comprehensive Stroke Center, Holmstedt said neurologists use a drug called TNK, short for tenecteplase, to break up blood clots in the brain that are causing strokes. But it’s not the only option.

“The second treatment for ischemic stroke, the most common type of stroke, is mechanical thrombectomy. This procedure is for a certain type of stroke caused by a large blood clot in the one of the arteries blocking the blood supply off to large territories of brain. It's a surgical procedure done endovascularly through the arteries. They run catheters up just like they do for heart catheters, but they run them all the way into the brain, and they actually pull the clot out,” Holmstedt said.

“The combination of the two – TNK and thrombectomy – is the absolute best for patients with those large blood vessel blockages,” referring to the brand name for the drug tenecteplase.

Holmstedt cited a recent case, involving a man no one would have expected to suffer a stroke.

“I treated a man on Sunday. Young, healthy, really fit. His wife witnessed him having a stroke. His right face started drooping. He stopped talking. Right side got weak; he got to the hospital. We first reached him through telemedicine. We gave him the clot-busting medicine within an hour of symptom onset and put him in a helicopter to fly to MUSC Charleston in anticipation that he would need the mechanical thrombectomy. But when he arrived, his symptoms were resolved. This case really reiterates how time is everything. The faster you get treatment from symptom onset, the better the outcomes.”

Telemedicine involves the use of technology to allow a medical specialist in one location to see and gather medical information about a patient in another hospital and recommend treatments. That means even people in areas without specialists on-site still have access to expert analysis and advice.

“A hundred percent of South Carolina is now covered within a 30-minute drive of an expert stroke doc via telemedicine. So South Carolina has made a tremendous improvement over the last decade with getting the treatments to the people in these rural communities.”

Holmstedt said it’s better to call 911 than get a regular ride to the hospital after a stroke because it ensures that the stroke team will be ready to take care of the patient immediately.

And if something seems off when you’re going about your daily activities, pay attention. “You know your body. You know when something's not right. If your body's not moving correctly or if it's numb and tingly on one side of your body, call 911.”

Making that call can help ensure that you arrive at the hospital within the window of time when you’re eligible for TNK. “We can only give it to people in a period of zero to four-and-a-half hours from the last time they were completely normal. And the earlier you treat from time of onset, the more likely you are to completely reverse or return basically back to normal.”