Stroke Center
Part of Stanford Health Care Neuroscience
Why Stanford Health Care
The Stanford Health Care Comprehensive Stroke Center provides major contributions to worldwide research of stroke prevention, diagnosis, and treatment.
Our Palo Alto center was the first designated Comprehensive Certified Stroke Center in the U.S., the highest level of certification. Our Pleasanton Stroke Center is a Stroke Center of Excellence.
What We Offer You for Stroke Prevention and Care
- Renowned expertise in caring for patients who are at high risk of stroke or who have experienced a stroke. Go to Conditions Treated
- Superior quality and outcomes that exceed national measures for prompt diagnosis and intervention, offering emergency stroke treatment up to 24 hours after stroke onset. Go to Treatments
- Care delivered by a broad team of stroke specialists who design a treatment and prevention plan to meet your needs. Go to Your Care Team
- Access to clinical trials that advance our ability to predict stroke risks and improve healing. Go to Clinical Trials
- Comprehensive support services including an innovative neurohospitalist program, to help you and your family focus on health and healing. Go to Support Services
- Ease of access at two nationally recognized stroke centers in Palo Atlo and Pleasanton in the East Bay, for excellent care close to home. Go to Accessing Care
Our Stroke Center team provides preventive care, diagnosis, and treatment for stroke and stroke-related issues. We provide the most comprehensive, specialized, and leading-edge treatments for every type of stroke, arteriovenous malformation (AVM), and aneurysm.
Stroke
Stroke is a condition in which brain cells suddenly die because of a lack of oxygen. A stroke can result from an obstruction in blood flow to the brain or a ruptured artery that feeds the brain. We treat:
- Ischemic stroke (blood clots)
- Hemorrhagic stroke (brain bleeds)
Stroke Awareness Saves Lives
Learn more about how stroke awareness can save your life or the life of a loved one.
Stroke-induced brain injury
When blood supply to part of the brain is blocked or cut off, oxygen no longer reaches brain tissue. As a result, brain cells die rapidly. This brain cell death causes stroke-induced brain injury. The injury's severity can vary based on the location, duration, and severity of the stroke.
Cerebrovascular disorders
These disorders are related to disease of the blood vessels that supply the brain. We care for people with conditions including:
- Dural arteriovenous fistulas, atypical connections between blood vessels
- Cavernous malformations (CM)
- Intracranial stenosis, narrowed vessels in the brain
- Carotid artery disease, including moyamoya disease
- Developmental venous anomalies (DVA) or venous angioma
Aneurysm
An aneurysm is an abnormal bulge or ballooning of a section of an artery. The artery wall weakens, increasing your risk of brain bleeding if the aneurysm leaks or ruptures. Bleeding from an aneurysm can be life-threatening. It can lead to a type of hemorrhagic stroke known as subarachnoid hemorrhage.
Arteriovenous malformation (AVM)
An AVM is an abnormal set of connections between arteries and veins, creating a tangle of blood vessels. AVMs most often form in the brain and spine. They may cause neurologic symptoms or bleeding.
Transient ischemic attack (TIA)
Sometimes called a mini-stroke, a transient ischemic attack occurs when blood flow to a part of the brain stops for a brief time. Symptoms are similar to stroke but typically last less than an hour before disappearing. A TIA increases your risk of having a stroke later.
Stroke Treatments
The Stanford Health Care Stroke Center offers a full spectrum of support services for people who experience a stroke, in addition to nationally recognized diagnostic services and treatments.
The best stroke outcomes depend on getting treatment as fast as possible. Stanford Health Care’s Life Flight Program provides 24-hour emergency air transport so you can receive advanced care right away. Our Emergency Department is equipped with the latest tools and technologies to assess your needs in the event of a stroke.
What to Expect
You will receive a thorough assessment to identify a potential stroke, the type, and the progression of any damage. We treat you with medicine, surgery, or both. Then we monitor you closely in our intensive care unit (ICU) until your condition becomes stable.
As you recover, you will typically move to the Inpatient Neurology or Neurosurgery unit for constant observation, treatment, and eventual rehabilitation. During your hospital stay, a dedicated, interdisciplinary team cares for you. Stanford Health Care's Neurohospitalist Program provides comprehensive care centered on your needs, with seamless transitions into each new stage.
Throughout your treatment, we answer the many questions you and your family will likely have as we prepare you to continue your rehabilitation and recovery.
Stroke Treatments
Once a stroke occurs, our specialists rapidly identify the cause and focus your treatment on correcting that cause. Our first goal is to prevent further stroke. Then we work closely with you and your entire care team to enhance your health and work toward your recovery.
Stroke surgery
We offer surgical treatments including:
Carotid endarterectomy (CEA)
This surgery removes clots and blockages from your carotid artery. It can prevent strokes in people who have carotid artery disease.
Interventional neuroradiology
We use minimally invasive procedures and catheters (small tubes in your blood vessels) to treat or prevent stroke. This technique can treat blood vessel diseases, tumors, and clots in the brain and spinal canal.
Stereotactic microsurgery for AVMs and aneurysm (CyberKnife)
We deliver high-dose X-rays to a targeted region in a painless, noninvasive procedure to treat brain and spine conditions. Specialized robotic tracking capabilities greatly reduce the amount of radiation to surrounding tissues.
Endovascular treatment of aneurysms
In this interventional neuroradiologic technique, your surgeon guides tiny coils into an aneurysm via a catheter. The procedure closes off the aneurysm from the surrounding circulation. By stopping blood flow to the aneurysm, we prevent the risk of hemorrhagic stroke in the future.
Revascularization of the blood supply
This surgical technique treats aneurysms or blocked cerebral arteries. Your surgeon provides a new route for blood to travel to the brain. The surgeon may graft another vessel to a cerebral artery to create a different source of blood flow to the brain.
Endovascular treatment of AVMs
In this endovascular treatment, your doctor introduces a “super glue” substance to the AVM via a tiny catheter. The substance reduces the size of the arteriovenous malformation and creates an avenue for your doctor to treat the AVM with another microsurgical procedure or radiation if needed.
Nonsurgical stroke treatments
In addition to surgery, we use medications and other therapies to prevent and treat stroke and help you recover. Your nonsurgical care may include:
Emergency medications
Emergency medications to treat stroke include thrombolytics, which help dissolve blood clots to reestablish the blood flow to the brain.
Medications to help prevent stroke
If you have a high risk for stroke, we prescribe medications including anticoagulants/antiplatelets (blood thinners) and antihypertensives, as well as medications to reduce cholesterol levels. These medications help control stroke risk factors.
Rehabilitation
Rehabilitation is a critical part of recovery to help you return to independent living after a stroke. We work with you to regain or build new capabilities in self-care, mobility, communication, and cognitive and social skills.
Programs and Services
In addition to the diagnostic and therapeutic services offered by the Stanford Stroke Center, we offer a full spectrum of allied patient care services through our Rehabilitation Services. Your resources include:
Individual assessment
We design a treatment and rehabilitation plan based on your unique needs. Depending on the area of the brain affected by the stroke, physical and mental damage may be mild or severe. Effects may range from dizziness and confusion to sensory loss or paralysis.
Your treatment and rehabilitation plan helps you regain function if you’ve experienced:
- Hemiparesis (paralysis on one side of the body)
- Aphasia (loss of ability to speak or understand language)
- Spatial-perceptual deficits
- Learning difficulties
- Memory loss
- Behavioral or emotional changes
- Loss of motor skills
Stroke rehabilitation services
After a mild stroke or if medical therapy was very effective, you may need little or no rehabilitation. Most stroke patients, however, benefit from some type of rehabilitation.
Stanford Health Care offers a wide variety of rehabilitation services to help you recover from a stroke. You may receive inpatient services or outpatient therapies, depending on your specific needs.
The ultimate goal of rehabilitation is to support you as you return to as independent a lifestyle as possible. Because of tremendous advances in stroke treatment, along with ever-improving rehabilitation techniques, the outlook for people who have had a stroke has never been more hopeful.
Our rehabilitation program features a caring, interdisciplinary team that may include:
- Doctors
- Physical, occupational, and recreational therapists
- Speech-language pathologists
- Neuropsychologists
- Clinical social workers and case managers
- Dietitians
- Rehabilitation nurses
Support groups
Stanford Health Care offers the Stanford Stroke Support Group in conjunction with the Pacific Stroke Association. In the group, you have the opportunity to increase your knowledge of diagnostic and treatment options and develop problem-solving and coping skills.
The support group provides a forum where you and your family can share experiences and concerns about rehabilitation, depression, and other daily concerns. We encourage all patients, at any stage of treatment, to participate. Contact the Neuroscience Supportive Care Program at 650-721-8500 or NSCP@stanfordhealthcare.org for more details.
Community resources
If you or a loved one has experienced disability as a result of stroke, many community resources can help you cope and learn to provide support and encouragement. The Stanford Stroke Center can provide you with an up-to-date list of community resources. Contact the Stroke Center at 650-723-6469 or strokecenter@med.stanford.edu.
Other resources
- American Stroke Association
- National Institute of Neurological Disorders and Stroke
- Pacific Stroke Association: support, education, and advocacy for people affected by stroke in San Mateo and Santa Clara counties
Comprehensive Stroke Center
The Joint Commission has certified the Stanford Health Care Stroke Center in Palo Alto as a Comprehensive Stroke Center. Stanford Health Care was the first hospital in the country to earn this certification, in 2012. Our Pleasanton Stroke Center is a Stroke Center of Excellence.
The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. The Joint Commission operates the accreditation program in collaboration with the American Heart Association/American Stroke Association.
Comprehensive Stroke Center certification means that we deliver rapid, high-quality care encompassing every treatment need for people at risk of or experiencing stroke. Our care options include:
- Nonsurgical treatments for stroke prevention
- Advanced surgical techniques
- Innovative interventional neuroradiology procedures
- Stroke rehabilitation
- Stroke support group
- Access to promising treatments in clinical trials
Stanford StrokeNet: Regional Stroke Trials Coordinating Center
Our Stroke Center is a Regional Stroke Trials Coordinating Center of the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Trials Network. This prestigious designation is awarded by the National Institutes of Health (NIH) to only 25 stroke centers in the nation.
As a key participant in major NIH stroke clinical trials, the center helps advance stroke prevention, treatment, and recovery. Participating centers share data and work together to help improve stroke care and outcomes for all patients.
Quality and Outcomes
Stanford Comprehensive Stroke Center continues to provide major contributions to worldwide research efforts aimed at understanding the complex mechanisms of stroke injury, treatment, diagnosis and prevention.
- Pioneered major advances in medical therapies, neurosurgical techniques, interventional neurological procedures, and advanced imaging
- Provided care for more than 26,000 inpatients with cerebrovascular disorders
- Participated in over 275 clinical stroke trials
- Designated the first Comprehensive Certified Stroke Center by The Joint Commission in 2012
- Expanded stroke and acute care neurology expertise via telemedicine
Our program strives to provide evidence-based and advanced comprehensive care for complex stroke patients. Every stroke patient's hospitalization is evaluated for timeliness and appropriateness of care to improve outcomes and experience.
The following are reported metrics for data collection period: January 2019 to December 2020.
|
1
Procedures |
1
Number of Patients |
1
# of patients with complications |
1
Complication Rate |
|---|---|---|---|
|
1
Death in Diagnostic Cerebral Angiogram |
1
783 |
1
0 |
1
0% |
|
1
Stroke in Diagnostic Cerebral Angiogram |
1
783 |
1
1 |
1
0.13% |
|
1
Procedure |
1
Number of Patients |
1
# of patients with complications |
1
Infection Rate |
|---|---|---|---|
|
1
External Ventricular Drain |
1
110 |
1
0 |
1
0% |
|
1
Procedure |
1
Number of Patients |
1
# OF PATIENTS WITH COMPLICATIONS |
1
Death |
|---|---|---|---|
|
1
Elective Asymptomatic |
1
82 |
1
0 |
1
0% |
Quality Process Measures
IV Alteplase (tPA, tissue plasminogen activator) is an enzyme involved in the breakdown of blood clots. The American Heart Association goal is administration of tPA for ischemic strokes within 60 minutes of arrival.
|
1
Intervention |
1
Best Time From ED Arrival to tPA Administration |
|---|---|
|
1
IV Alteplase (tPA) |
1
14 minutes |
|
1
Intervention |
1
Median Time From ED Arrival to tPA Administration |
|---|---|
|
1
IV Alteplase (tPA) |
1
25 minutes |
The Stanford Health Care goal for time to CT imaging is 20 minutes.
|
1
imaging |
1
Best time arrival to ct |
|---|---|
|
1
ED Arrival by Ambulance to CT Scan |
1
3 minutes |
|
1
imaging |
1
Median time arrival to ct |
|---|---|
|
1
ED Arrival by Ambulance to CT Scan |
1
6 minutes |
# of patients transferred to Stanford Health Care for mechanical thrombectomy intervention from hospitals in Northern California, the Central Valley, and Central Coast.
|
1
# OF TRANSFER PATIENTS 2019 |
1
# OF TRANSFER PATIENTS 2020 |
|---|---|
|
1
145 |
1
146 |
Your Care Team
Your Doctors
Vascular Neurologists
A vascular neurologist is a medical doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system. They treat conditions such as stroke.
View All 11 Vascular Neurologists »Neurohospitalists
Neurohospitalists are neurologists who have completed additional training to care for acutely ill, clinically complex patients with neurologic disease. These board-certified neurologists are expert clinicians who provide advanced care for patients who need multispecialty care.
View All {0} Neurohospitalists »Neurosurgeons
Neurosurgeons specialize in treating brain and spinal cord cancer through traditional (open) and minimally invasive surgery and CyberKnife radiosurgery, a noninvasive form of radiation therapy.
View All {0} Neurosurgeons »Interventional Neuroradiologist
This medical specialty is also called neurointerventional surgery. Interventional neuroradiology is a subspecialty within radiology. It also involves catheters and radiology to diagnose and treat neurological conditions and diseases.
View All {0} Interventional Neuroradiologists »Stanford is an Academic Medical Center, which is a type of hospital setting where doctors teach the entire spectrum of medical education. Students range from beginning medical students to fully licensed and practicing doctors completing advanced subspecialty training. Stanford Medicine is a partnership between Stanford University School of Medicine and Stanford Health Care. Since Stanford is a teaching hospital, you can expect to meet many providers and providers in training.
- Attending physician: a doctor who supervises doctors in training or in medical school
- Fellow: a doctor doing postgraduate level work and specializing in care of patients with specific conditions
- Resident: a doctor who has graduated from medical school and is in training (also called “residency”) here at Stanford. A resident is also called an intern.
- Medical student: a student who is currently enrolled in medical school with the goal of becoming a doctor
Extended Care Team
Our oncology-certified health care providers work with your oncologist to help with diagnosis and treatment. APPs may recommend medications, lifestyle changes, and services such as genetic counseling. An APP can be a nurse practitioner (NP), physician's assistant (PA), or clinical nurse specialist (CNS).
Multidisciplinary care coordinators are registered nurses who provide one-on-one support throughout your care journey. They help you navigate from your first contact with us to follow-up care, assessing your needs, answering your questions, making referrals, coordinating appointments, and providing education.
- Medical Assistants take you to your exam room after you check in for your appointments. They check your vital signs before your doctor sees you.
- New Patient Coordinators contact you before your first appointment and help you prepare by providing the information you need to know and bring with you.
- Patient Access Representatives greet you at the front desk and register you for your appointments.
- ITA Schedulers schedule your appointments if you have apheresis (a specific type of blood transfusion) or chemotherapy.
- Surgery Schedulers call you to arrange the details for meeting with a surgical oncologist or reconstruction surgeon or the surgery.
- Occupational therapists are skilled practitioners who provide rehabilitation care to help you regain strength and functional ability during and after treatment for cancer. They help you with activities of daily living such as bathing, dressing, managing your medications, and driving.
- Physical therapists work with you and your family to recover your physical function after treatment, such as improving your:
- Strength, especially in the upper body
- Sensation, to relieve numbness in treated areas
- Range of motion, to reduce stiffness and pain
- Movement control, to improve endurance and reduce fatigue
If you qualify for a clinical trial, our research coordinators guide you through the process. They educate you about what to expect during the study, answer your questions, and schedule your appointments.
These specialists are experts in communication. The speech pathologists with the Stanford Medicine Neuroscience program have added training to help people with varous neurological conditions that may affect their abilit to speak or swallow.
Support Services
At Stanford Health Care, we take care of the details so that you can focus on your recovery and rehabilitation after a stroke. Our neurologists, vascular surgeons, and other doctors work as a team with physical and occupational therapists, registered dietitians, speech-language pathologists, and rehabilitation nurses to support your recovery.
When you come to the Stanford Neuroscience Health Center, you can often see several providers on the same day, in the same clinic. We offer on-site imaging in each of our locations, providing faster access to treatment.
For your convenience, you may check in for all same-day appointments at the Stanford Neuroscience Health Center through a centralized check-in desk near the front lobby. You can access all outpatient services and on-site pre-surgery consultations at the center.
If you or someone you know experiences symptoms of stroke, seek emergency help immediately. CALL 911—do not wait!
For Referring Physicians
PHYSICIAN HELPLINE
Fax: 650-320-9443
Monday – Friday, 8 a.m. – 5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referring Physicians.
You may also submit a web referral or complete a referral form and fax it to 650-320-9443 or e-mail the Referral Center at ReferralCenter@stanfordhealthcare.org
To schedule an appointment, please call:
Palo Alto: 650-723-6469
Pleasanton: 925-263-5588