UI Department of Neurology

Did You Know?

Stroke Rating System

Harold Adams, MD, of the UI Stroke Center led the development of a clinical rating system for classifying the severity of strokes that is now used world-wide.

The UI Stroke Center, in collaboration with several colleagues from around the country, published a scientific statement from the stroke Council of the American Stroke Association on the guidelines for the early management of patients with ischemic stroke.

Collaboration

The Human Brain Research Laboratory represents a multidisciplinary scientific undertaking, involving collaborative research between surgeon–scientists and basic neuroscientists.

These scientists come from around the world and are working together to develop advances into how humans process auditory information, and emotional stimuli. It also incorporates the world's leading human subjects electrophysiology research facility, which contributes to the efforts supporting neuroscience translational research. Patient care is directly impacted by the expertise of this research group in instances where epilepsy patients have complex auras, particularly of an auditory nature. The electrophysiological recording methods developed for research purposes are well suited to identify seizure foci as well in these patients.

Hybrid OR

UI Neurosurgeon David Hasan performs both open and endovascular procedures in our newly constructed hybrid operating room.

Directing a fully integrated, multidisciplinary team, he follows our traditional collaborative formula for outstanding patient care that is based on a strong and mutually supportive partnership between our neurosciences faculty, and our neurosurgery colleagues practicing in the community, incuding neurologists, neurosurgeons, general practitioners, emergency room physicians, and other health care providers throughout the region.

Stories of Hope

A Stroke? 20 Is Too Young

Not many college sophomores give the risk of stroke much thought. Alexis Swedlund didn't, so even after she experienced seven to eight minutes of numbness and shaking on the left side of her body, she was inclined to ignore the episode and get on with her day.

Swedlund, an active and involved University of Iowa student, had returned to Iowa City from a day of lobbying legislators in Des Moines on behalf of the student government. Walking along a busy street near the heart of campus, she was talking on her cell phone with a friend when the symptoms occurred. "The whole left side of my body started to go numb and started to shake," Swedlund said. She dropped her phone, noticing that even her tongue felt numb.

Rather than call 911 when the symptoms subsided, Swedlund called her parents, who insisted she go to an emergency room. In classic student fashion, she hopped on a Cambus—the UI's free, campus–wide bus service—which took her to UI Hospitals and Clinics. "I didn't think a whole lot of it, because I felt fine at that point," she said.

Her visit to the Emergency Treatment Center led to a hospital stay of several days, during which Swedlund's care team performed MRI scans and other tests to diagnose her problem. They discovered a heart defect called a patent foramen ovale, or PFO—essentially, an opening between the right and left atria that allows blood to flow directly from one to the other without passing through the lungs.

Such a defect can allow an embolus, or small blood clot, to enter the carotid artery, blocking the flow of blood to the brain and causing stroke symptoms. Conventional treatment has been to prescribe blood-thinning medications to inhibit the formation of emboli. If it became necessary to repair the heart defect itself, open–heart surgery would be required.

As it happens, though, the timing of Swedlund's episode coincided with the enrollment period for a study of a new device to repair PFOs. The device, NMT Medical's STARFlex septal repair implant, closes the opening between the atria. Best of all, it can be put in place by an interventional cardiologist using a catheter, avoiding the pain, long recovery, and expense of major surgery. Randomly assigned to the group receiving the implants, Swedlund underwent the procedure in April 2008.

Following up on the implant procedure, Swedlund has worked closely with Patricia Davis, MD, professor of neurology, and neurosciences research staff,. "Every time I go in they make me do the finger–to–nose test," Swedlund joked. She takes low-dose aspirin to inhibit the formation of blood clots, rather than a prescription drug such as warfarin or heparin, which can have more noticeable side effects.

UI Department of Neurology :: 200 Hawkins Drive :: Iowa City, IA 52242 :: Phone: 319-384-8111 Fax: 319-384-7199 ::e-mail: neurology-scheduling@uiowa.edu