Cerebrovascular Diseases Department
"With an acute ischemic stroke, we are always racing against time. Every minute of delay means thousands of nerve cells could be irreversibly lost. Modern treatments, such as thrombolysis and endovascular thrombectomy, allow us to restore blood flow in blocked vessels, but they are only effective within a specific therapeutic window. Therefore, it is crucial that the patient is admitted to a specialized unit as quickly as possible, where we can perform computed tomography or magnetic resonance imaging, angiography, and initiate treatment immediately.
In our department, we operate on a 'door-to-bed' principle: a patient with a suspected stroke is evaluated by a neurologist and a neurosurgeon, urgent diagnostics are performed, and a team-based decision is made regarding the treatment strategy. This approach allows us to significantly reduce the time to treatment initiation and, consequently, improve outcomes."
Diagnostics, treatment, endovascular interventions, and early rehabilitation are all conducted within the same hospital, which significantly reduces the time to treatment and increases the chances of recovery.
A patient with a suspected stroke is immediately placed under the care of a neurologist and a neurosurgeon. The team works synchronously, allowing for urgent decision-making regarding thrombolysis or thrombectomy.
3 SCT scanners, 2 MRI scanners, 2 angiography suites, modern ultrasound equipment, comprehensive laboratory facilities, and rapid CT angiography ensure accurate and prompt diagnoses.
Neurologists, neurosurgeons, endovascular surgeons, cardiologists, rehabilitation doctors, speech therapists, psychologists, physical therapists, and occupational therapists are all involved in the treatment process. This ensures that every patient receives comprehensive care addressing all aspects of their condition.
Specialists from the Rehabilitation Center are engaged in patient care from the start. Initial exercises and therapies are introduced within the first few days, greatly improving the chances of regaining motor, speech, and daily living skills.
We do more than just handle standard clinical scenarios. Our department regularly identifies rare causes of stroke, including congenital heart defects, blood clotting disorders, and other factors that often go unnoticed in other medical facilities.
We don't just treat the acute episode; we help patients understand how to manage blood pressure, heart rate, blood sugar levels, and other risk factors. This significantly reduces the likelihood of a recurrent stroke.
With 11 rooms of various types, including private rooms, our continuous monitoring and 24/7 support from junior and nursing staff create an environment where patients receive attentive care during their most vulnerable period.
Our medical psychologist and rehabilitation team help patients and their families adapt to lifestyle changes, reduce anxiety, overcome fears, and rebuild confidence in their own abilities.
What Sets Our Department Apart
The Cerebrovascular Diseases Department is a specialized unit that concentrates the resources, expertise, and technologies required to assist patients with stroke and other acute cerebrovascular events.
Our department most frequently admits patients with:
- acute ischemic stroke
- transient ischemic attacks (TIAs)
- decompensated vascular encephalopathy
An ischemic stroke is an acute disruption of cerebral blood flow that occurs when a blood vessel is blocked by a blood clot or atherosclerotic plaque. As a result, a part of the brain is deprived of oxygen, and nerve cells begin to die. If blood flow is not restored in time, this can lead to permanent paralysis, speech and vision impairment, or the loss of other functions.
A transient ischemic attack starts like a typical ischemic stroke, but the symptoms resolve within 24 hours. However, it is a serious warning sign that the vascular system is operating at its limit, and without treatment, the risk of a full-blown stroke increases significantly.
Vascular encephalopathy is a chronic brain disorder associated with prolonged impairment of blood supply. During a decompensation phase, a patient may experience a sharp decline in memory, balance, mood, and other functions, which also requires inpatient treatment.
These are conditions that require the most rapid diagnosis, strict adherence to protocols, and continuous monitoring. It is essential not only to manage the acute episode but also to prevent recurrent events, stabilize the vascular system, and initiate early rehabilitation.
The hallmark of our approach is its multidisciplinary nature. Neurologists, endovascular surgeons, cardiologists, functional diagnostics specialists, rehabilitation doctors, speech therapists, psychologists, physical therapists, and occupational therapists are involved in managing each case. This allows us to see the entire clinical picture rather than just an isolated symptom.
Symptoms Requiring Immediate Action
A stroke is a medical emergency where you cannot "wait until tomorrow." The sooner a person reaches a specialized stroke unit, the higher the chances of recovery.
Warning signs may include:
- sudden numbness or weakness in the face, arm, or leg, especially on one side of the body;
- sudden facial drooping;
- sudden speech difficulty—the person is hard to understand or unable to speak clearly;
- sudden loss of vision in one eye or double vision;
- sudden loss of balance, coordination, or an unsteady gait;
- a sudden, severe headache unlike any usual headache.
If you notice these symptoms in yourself or your loved ones, it is critical to call an ambulance immediately and mention a suspected stroke. The faster the patient is delivered to a specialized unit, the more options there are for thrombolysis or endovascular thrombectomy.
Diagnostic Capabilities
One of the key priorities when admitting a patient with a suspected stroke is to confirm or rule out the diagnosis as quickly as possible and determine the type of lesion (ischemic or hemorrhagic). Further treatment depends entirely on this.
At Mechnikov Hospital, we have access to:
- 3 spiral computed tomography (SCT) scanners;
- 2 magnetic resonance imaging (MRI) scanners;
- a digital X-ray machine;
- two angiography systems for vascular assessment;
- ultrasound machines for examining blood vessels, the heart, and internal organs;
- ECG machines;
- an EEG machine;
- Holter monitors for 24-hour ECG recording;
- comprehensive laboratory testing.
This allows us to perform a brain SCT or MRI, CT angiography, evaluate the condition of blood vessels and the heart, and identify concomitant risk factors in the shortest possible time. Importantly, all of this is available within a single hospital, without the need to transfer the patient to other facilities.
We work closely with the Center for Vascular Neurosurgery, the Endovascular Surgery Department, Cardiology, Endocrinology, and the Functional Diagnostics Department. This level of collaboration enables rapid decision-making regarding thrombolysis, thrombectomy, and the correction of blood pressure, heart rate, and other vital parameters.
Modern Treatment Methods
Treatment in our department is based on evidence-based practices and international guidelines for the management of patients with acute cerebrovascular events. We utilize:
- thrombolysis—the administration of a specialized drug that dissolves blood clots in cerebral vessels
- endovascular thrombectomy—a minimally invasive procedure where the clot is removed from the vessel using a catheter
- medical therapy to stabilize blood pressure and heart rate, as well as manage risk factors
- early rehabilitation—involving rehabilitation specialists from the very first days post-stroke
The treatment method is selected individually, depending on the time elapsed since symptom onset, lesion location, vascular condition, patient age, and comorbidities.
Early rehabilitation is an integral part of the treatment. The hospital features a Rehabilitation Center whose specialists help restore motor functions, speech, swallowing, and self-care skills. Physical therapists, occupational therapists, speech therapists, and a medical psychologist are all involved in patient care.
Our Team
A complete team of specialists oversees each patient:
- neurologists;
- physical and rehabilitation medicine (PRM) physicians;
- physical therapists;
- occupational therapists;
- speech therapists;
- medical psychologists;
- nursing and junior medical staff.
Thanks to the optimal delegation of responsibilities within the multidisciplinary team, every specialist knows their role on the journey from acute illness to recovery. Doctors oversee diagnosis and treatment, rehabilitation specialists focus on restoring movement and functional skills, speech therapists manage speech and swallowing, the psychologist handles emotional well-being, and the nurses provide daily care and monitoring.
Patient Accommodations
The department features 11 patient rooms:
- 5 four-bed rooms;
- 4 two-bed rooms;
- 2 single superior comfort rooms.
Nursing and junior medical staff are on duty 24/7, providing medical care, meals, and assistance. Relatives are allowed to visit, as family support plays a crucial role in the post-stroke recovery process.
The department does not have a day hospital, but some follow-up examinations and consultations are conducted on an outpatient basis after discharge, closer to the patient's home.
Recommendations for Patients and Their Families
A stroke cannot always be predicted, but its consequences can be significantly mitigated. It is essential to:
- know the main symptoms of a stroke and not hesitate to call an ambulance if they occur
- monitor blood pressure, blood sugar, and cholesterol levels
- quit smoking
- consult a doctor regularly if risk factors are present (hypertension, diabetes, heart disease, atrial fibrillation)
After suffering a stroke, it is important not to face the diagnosis alone. Regular check-ups, compliance with medical recommendations, participation in rehabilitation programs, and the support of loved ones help significantly improve the quality of life.
We understand that a stroke is always highly stressful for patients and their families. That is why our team not only provides treatment but also explains every step, offers emotional support, and helps patients adapt to the changes that have occurred.
When a stroke is suspected, time is of the essence. If you or your loved ones suddenly experience symptoms of cerebrovascular impairment, act immediately. The Cerebrovascular Diseases Department at Mechnikov Hospital operates with a team that handles the most complex cases daily and knows exactly what to do in critical moments. Reach out for help—we are here to provide a timely diagnosis, deliver advanced treatment, and help you navigate the path from the acute phase to recovery, aiming for the highest possible quality of life!