Stroke Program

The Stroke Service
We are a team dedicated to the management of patients with stroke and stroke symptoms, as well as those at risk of a stroke. We offer stroke patients a comprehensive diagnostic evaluation to determine the specific type of stroke, and tailor the management to this specific cause of the stroke. The diagnostic studies include state-of-the-art radiologic and ultrasound imaging, and treatment options include the use of clot-dissolving agents such as t-PA, as well as a number of medications used for the prevention of future strokes. In collaboration with the Departments of Neurosurgery and Vascular Surgery, we also offer surgical treatments for the prevention of stroke, such as carotid endarterectomy and cerebral aneurysm surgery. For the prevention of stroke, we offer a comprehensive study and management of the stroke risk factors. These are generally identified and managed in concert with the primary care physicians. Some of the most common risk factors for stroke include:

	Hypertension
	Diabetes
	Heart disease, especially atrial fibrillation
	Elevated blood lipids
	Smoking
	Excessive use of alcohol

Many of these risk factors can be modified with specific treatments or changes in life-style, and their control can substantially reduce a person’s risk of having a stroke.

Research
Our stroke team conducts research in various areas. Research aimed at the identification and impact of stroke risk factors is conducted primarily at the Framingham Study, an NIH-funded study that is administered by researchers at Boston University. Our team member, Philip A. Wolf, M.D. is the Principal Investigator and also directs stroke-related research in the Framingham Study. Through this study, the longest running prospective epidemiological study in history, which has been on-going continuously for over 50 years, most of the currently known risk factors for stroke have been identified. Newer modifiable risk factors are also being recognized such as elevated blood levels of homocysteine and C-Reactive protein in stroke-prone persons. This has led to the institution of therapies that can substantially reduce the risk of stroke in high risk individuals. Other areas of research in acute stroke, which concentrate in issues of diagnosis and management of different types of stroke, are conducted by team members Carlos S. Kase, M.D. and Viken L. Babikian, M.D. These areas of clinical research include:

	Cerebral embolism
	Cerebral thrombosis
	Lacunar stroke
	Intracerebral hemorrhage
	Subarachnoid hemorrhage

Facilities
In-patient care by the stroke team is provided at our main hospital, Boston Medical Center, on both campuses, the Newton and the Harrison Pavilions. The Medical Center has modern patient care facilities including intensive care units, as well as state-of-the-art imaging with CT scan and magnetic resonance imaging (MRI). Out-patient care is provided at the offices of the Boston University Neurology Associates in the Doctor’s Office Building.

Education
Our stroke group offers an approved Stroke Fellowship program, for one to two years, to train young neurologists in the discipline of stroke. This includes exposure to the wide variety of patients evaluated at Boston Medical Center (approximately 350 patients per year), along with opportunities for training in diagnostic ultrasonography (Duplex and Transcranial Doppler sonography), and availability of research opportunities using the wealth of data from the Framingham Study.

Faculty