Telemedicine brings stroke expertise bedside

By Hormozd Borzorgchami, M.D.

Just a few days after a stroke left Emil Evans paralyzed from the tip of his right toe to the tip of his right finger, he was back raking leaves in the yard of his McMinnville home. The OHSU Telemedicine Network played a vital role in his remarkable rebound by bringing the best stroke treatment expertise to his bedside minutes after he arrived at Willamette Valley Medical Center.

Evans was struck by a dizzy spell while standing in the kitchen of his McMinnville home Nov. 4. Paramedics took Evans to WVMC, and Siobhan Gray, M.D., the emergency room physician who examined Evans, immediately suspected he had suffered a stroke.

Gray sent Evans for a CT scan and called OHSU, requesting a telemedicine consultation. By the time Evans returned from his CT scan, I had connected to Willamette Valley Medical Center’s telemedicine cart. This secure two-way audio-video equipment allowed me to examine Evans, ask his family questions about his medical history and work with Dr. Gray to begin treatment. He was then transported to OHSU and taken directly to angiography, where a clot was removed using one of the latest stroke treatment devices. Two days later, he was headed home.

Dr. Gray , left, watches Dr. Borzogchami beam into the emergency room on a telemedicine robot.

As the Evans case demonstrates, the best treatment for ischemic stroke is early treatment. Many of our acute stroke therapies, including the clot-busting t-PA that Evans initially received, are time-dependent, and the sooner a patient can receive treatment to help remove the blood clot, the better the chance that they will recover.

These therapies are also complex and require efficient coordination of care from stroke centers that can provide comprehensive treatment so that care is administered effectively and appropriately.  Since adding telestroke services to the OHSU Telemedicine Network, we have been able to provide comprehensive stroke expertise throughout Oregon almost instantaneously 24 hours a day, seven days a week.

Check out this video to hear Evans tell his story – an example of how the OHSU Telemedicine Network is providing rapid assessment of stroke victims by subspecialists and how this translates to a swift and effective treatment. Or click here to download the OHSU Extra app from iTunes, and watch the story about telemedicine and stroke on your iPad.

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Hormozd Bozorgchami, M.D., is an OHSU stroke neurologist. Dr.
Bozorgchami’s clinical interests include acute stroke treatment and gender
differences in responses to acute stroke therapies.
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