Stroke Care at University of Miami Health System

BE FAST is the key to stroke prevention

Dr. Negar Asdaghi is a neurologist at University of Miami Health System. For more information on the diagnosis and treatment of stroke or to make an appointment, call 305-243-3100 or visit the University of Miami's health news blog 

April Bowers was rattled the first time she experienced tingling in her hand, numbness on one side of her body, and difficulty speaking. But on the advice of a physician, she dismissed it as a nothing more than a bad headache, sometimes called a migraine with aura. April returned to her daily routine as a mom of young children and tried not to focus on the incident. 
“It was easy for me to brush it off as nothing serious and that was my first mistake,” she says. “I should have pushed harder.”
Last December, after another similar episode, April made an appointment with Dr. Negar Asdaghi, a stroke neurologist at University of Miami Health System. While sitting in the exam room, her symptoms returned. “I started having some eye pain again, and seeing kaleidoscope rainbows in my eyes. I just all of a sudden went numb again.”
Following an extensive assessment that included vascular imaging, Dr. Asdaghi discovered that there is tear in April’s carotid artery, which supplies blood to the brain. Also called a dissection, his form of damage to the carotid artery is a common cause of transient ischemic attacks (TIA) and strokes in people younger than age 50.
Signs of mild stroke and TIA can be easy to miss. Symptoms like April’s might come without warning and go away just as quickly. An expert in mild stroke, Dr. Asdaghi warns that seeking immediate medical attention is critical when it comes to prevent damage to the brain as a result of a stroke. 
“For every minute that that blockage is there, you lose approximately 1 million neurons. Literally seconds matter,” she says.
Studies show that approximately 1 in 10 patients who have suffered a mild stroke, or TIA, will experience another, bigger stroke event, often within 24 hours, says Dr. Asdaghi. To most effectively treat a stroke, the team at UHealth meets patients in the ambulance bay to begin neurological assessments as quickly as possible. They call this a negative “door time.”
“The mantra that we use is time is brain,” says Dr. Asdaghi. “So, from the moment that we’re notified about the possibility of a stroke alert, until the time we’re able to assess the patient, get all the appropriate imaging, and potentially deliver life-saving medication, we’re on a clock.”
Early recognition of stroke and early presentation to the hospital are the first steps in reducing the burden of stroke related mortality and morbidity.  But one in three people cannot name even a single stroke symptom, says Dr. Asdaghi. The acronym she teaches her medical residents and patients is BE FAST. Patients should be aware that problems with balance, vision (eye), droopiness or numbness in the face, difficulty moving the arm or leg, and speech impairment are all signs of stroke. The “T” in BE FAST stands for time.
Dr. Asdaghi says, “In a large stroke, on average, Every minute costs you 1 million neurons. Do you really want to pay that price? So, BE FAST, go and seek emergency medical attention.”
April is currently on an individualized treatment regimen prescribed by Dr. Asdaghi that should prevent further strokes. “I like running around with my kids. Some of those things are on hold right now, but I’d like to get back to being active,” she says. “I feel like I’ve been given the blessing of a warning. That’s how I’m trying to look at it.”


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