UB Project Educates Community About Stroke

BUFFALO, N.Y. -- Only a few years ago, having a stroke brought disability as surely as sunrise brought dawn. The idea that a person could "recover" from a stroke was not even on the horizon.

Clinical-research advances during the past decade changed that. University at Buffalo neurosurgeons and others now can save stroke patients from certain disability using new clot-busting drugs and new drug-delivery methods. They speak of stroke as a "brain attack." If patients know the symptoms and get to the hospital soon enough, they can avoid the often-debilitating damage an untreated stroke can cause.

The problem has been getting that message to the public.

In May 1997 -- May has been designated "stroke month" -- Lee Guterman, M.D., Ph.D., UB associate professor of neurosurgery, and his colleagues in the UB Department of Neurosurgery decided to begin a project to help educate the public about stroke's symptoms and risk factors. The project had particular resonance in Buffalo and environs, where stroke risk is higher than the national average. The result was the Western New York Stroke Screening Program.

"The purpose of the screening program, despite its name, was not so much to identify people at risk, which we do, but to get the word out about the signs and symptoms of stroke," Guterman said.

"The main message we want to get across to people is that stroke is a treatable disease. If they recognize the symptoms and get help quickly, there is a good chance to reverse the stroke. We wanted to do this as a community service."

The first screening that year took place in a booth in a local mall. A team of physicians, nurses, dietitians, ultrasound operators and support staff took heart-rate and blood-pressure readings and administered sonograms of the carotid artery to find out if there was any blockage.

The team offered the National Stroke Association's risk-factor assessment, provided nutrition counseling and presented a video on stroke's warning signs. The final step was a brief evaluation of all data by a neurosurgeon or neurologist. All services were provided free of charge.

People stood in line for hours waiting to be screened: Still, more than 200 had to be turned away. The team screened 1,000 people over three days at a second mall event, but the process was chaotic. It was decided to target senior-citizen centers from then on to increase efficiency and make the process more manageable.

Over the following two years, events were held at eight centers and one corporation. To date, team members have screened and provided stroke information to 3,200 people.

Letters have been sent to physicians of persons who were found to be at high risk of stroke. Guterman said 30 percent of participants had "reportable" disease.

Incidence of stroke is high in the Western New York population at large for several reasons, the most telling of which is a long history of smoking, unhealthy eating habits and obesity, he said. Stroke risk also increases with age, he noted, and the region has an increasingly senior population.

The project began as a solely volunteer effort, but since has received monetary support from Independent Health, Kalieda Health and the Women's Board at Millard Fillmore Hospital. Acuson Corporation and Hewlett Packard have donated the ultrasound equipment.

The group is producing its own educational video to promote the idea that stroke is treatable. Members are planning to bring their screening program into local companies -- they already have worked with the Buffalo Police Department and Airsep Corporation -- and to enroll people at high risk in education classes on-site to encourage changes in lifestyles that promote stroke.

The database of screened patients also will provide rich potential for research, Guterman said. The group presented the results at a recent professional meeting of its first study based on data from those screened. The study showed that ultrasound screening of the carotid artery is a reliable and cost-effect way to identify people with a condition called asymptomatic carotid artery stenosis, a significant stroke risk factor.

That study was headed by Adnan I. Qureshi, M.D., clinical instructor in the UB Department of Neurosurgery.

Guterman said that, among other future research projects, team members will assess the effect of their educational program on modifying risk factors.